Estimation of the Lung Function Using Acoustic Features of the Voluntary Cough

A noval pulmonary function evaluation method based on ResNet50 + SVR model and cough

Traditionally, the clinical evaluation of respiratory diseases was pulmonary function testing, which can be used for the detection of severity and prognosis through pulmonary function parameters. However, this method is limited by the complex process, which is impossible for patients to monitor daily. In order to evaluate pulmonary function parameters conveniently with less time and location restrictions, cough sound is the substitute parameter. In this paper, 371 cough sounds segments from 150 individuals were separated into 309 and 62 as the training and test samples. Short-time Fourier transform (STFT) was applied to transform cough sound into spectrogram, and ResNet50 model was used to extract 2048-dimensional features. Through support vector regression (SVR) model with biological attributes, the data were regressed with pulmonary function parameters, FEV1, FEV1%, FEV1/FVC, FVC, FVC%, and the performance of this models was evaluated with fivefold cross-validation. Combines with deep learning and machine learning technologies, the better results in the case of small samples were achieved. Using the coefficient of determination (R2), the ResNet50 + SVR model shows best performance in five basic pulmonary function parameters evaluation as FEV1(0.94), FEV1%(0.84), FEV1/FVC(0.68), FVC(0.92), and FVC%(0.72). This ResNet50 + SVR hybrid model shows excellent evaluation of pulmonary function parameters during coughing, making it possible to realize a simple and rapid evaluation for pneumonia patients. The technology implemented in this paper is beneficial in judge the patient's condition, realize early screening of respiratory diseases, evaluate postoperative disease changes and detect respiratory infectious diseases without time and location restrictions.

A forced cough sound based pulmonary function assessment method by using machine learning

Pulmonary function testing (PFT) has important clinical value for the early detection of lung diseases, assessment of the disease severity, causes identification of dyspnea, and monitoring of critical patients. However, traditional PFT can only be carried out in a hospital environment, and it is challenging to meet the needs for daily and frequent evaluation of chronic respiratory diseases. In this study, we propose a novel method for accurately assessing pulmonary function by analyzing recorded forced cough sounds by mobile device without time and location restrictions. In the experiment, 309 clips of cough sound segments were separated from 133 patients who underwent PFT by using Audacity software. There are 247 clips of training samples and 62 clips of testing samples. Totally 52 features were extracted from the dataset, and principal component analysis (PCA) was used for feature reduction. Combined with biological attributes, the normalized features were regressed by using machine learning models with pulmonary function parameters (i.e., FEV1, FVC, FEV1/FVC, FEV1%, and FVC%). And a 5-fold cross-validation was applied to evaluate the performance of the regression models. As described in the experimental result, the result of coefficient of determination (R2) indicates that the support vector regression (SVR) model performed best in assessing FVC (0.84), FEV1% (0.61), and FVC% (0.62) among these models. The gradient boosting regression (GBR) model performs best in evaluating FEV1 (0.86) and FEV1/FVC (0.54). The result confirmed that the proposed method was capable of accurately assessing pulmonary function with forced cough sound. Besides, the cough sound sampling by a smartphone made it possible to conduct sampling and assess pulmonary function frequently in the home environment.

Predicting frailty in older adults using vocal biomarkers: a cross-sectional study

Background

Frailty is a common issue in the aging population. Given that frailty syndrome is little discussed in the literature on the aging voice, the current study aims to examine the relationship between frailty and vocal biomarkers in older people.

Methods

Participants aged ≥ 60 years visiting geriatric outpatient clinics were recruited. They underwent frailty assessment (Cardiovascular Health Study [CHS] index; Study of Osteoporotic Fractures [SOF] index; and Fatigue, Resistance, Ambulation, Illness, and Loss of weight [FRAIL] index) and were asked to pronounce a sustained vowel /a/ for approximately 1 s. Four voice parameters were assessed: average number of zero crossings (A1), variations in local peaks and valleys (A2), variations in first and second formant frequencies (A3), and spectral energy ratio (A4).

Results

Among 277 older adults, increased A1 was associated with a lower likelihood of frailty as defined by SOF (odds ratio [OR] 0.84, 95% confidence interval [CI] 0.74–0.96). Participants with larger A2 values were more likely to be frail, as defined by FRAIL and CHS (FRAIL: OR 1.41, 95% CI 1.12–1.79; CHS: OR 1.38, 95% CI 1.10–1.75). Sex differences were observed across the three frailty indices. In male participants, an increase in A3 by 10 points increased the odds of frailty by almost 7% (SOF: OR 1.07, 95% CI 1.02–1.12), 6% (FRAIL: OR 1.06, 95% CI 1.02–1.11), or 6% (CHS: OR 1.06, 95% CI 1.01–1.11). In female participants, an increase in A4 by 0.1 conferred a significant 2.8-fold (SOF: OR 2.81, 95% CI 1.71–4.62), 2.3-fold (FRAIL: OR 2.31, 95% CI 1.45–3.68), or 2.8-fold (CHS: OR 2.82, 95% CI 1.76–4.51, CHS) increased odds of frailty.

Conclusions

Vocal biomarkers, especially spectral-domain voice parameters, might have potential for estimating frailty, as a non-invasive, instantaneous, objective, and cost-effective estimation tool, and demonstrating sex differences for individualised treatment of frailty.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12877-022-03237-7.

Deep Multivariate Domain Translation for Device Invariant Pulmonary Patient Identification from Cough and Speech Sounds

Pulmonary audio sensing from cough and speech sounds in commodity mobile and wearable devices is increasingly used for remote pulmonary patient monitoring, home healthcare, and automated disease analysis. Patient identification is important for such applications to ensure system accuracy and integrity, and thus avoiding errors and misdiagnosis. Widespread usage and deployment of such patient identification models across various devices are challenging due to domain shift of acoustic features because of device heterogeneity. Because of this phenomenon, a patient identification model developed using audio data collected with one type of device is not usable when deployed in another type of device, which is a concern for model portability and general usability. This paper presents a framework utilizing a multivariate deep neural network regressor as a feature translator between source device and target device domains to reduce the effect of domain shift for better model portability. Extensive and empirical experiments of our translation framework consisting of two different human sound (speech and cough) based pulmonary patient identification tasks using audio data collected from 91 real patients demonstrate that it can recover up to 64.8% of lost accuracy due to domain shift across two common and widely used mobile and wearable devices: smartphone and smartwatch. Clinical Relevance- The methods presented in this paper will enable efficient and easy portability of pulmonary patient identification models from cough and speech across various mobile and wearable devices used by a patient.

A systematic review on cough sound analysis for Covid-19 diagnosis and screening: is my cough sound COVID-19?

For COVID-19, the need for robust, inexpensive, and accessible screening becomes critical. Even though symptoms present differently, cough is still taken as one of the primary symptoms in severe and non-severe infections alike. For mass screening in resource-constrained regions, artificial intelligence (AI)-guided tools have progressively contributed to detect/screen COVID-19 infections using cough sounds. Therefore, in this article, we review state-of-the-art works in both years 2020 and 2021 by considering AI-guided tools to analyze cough sound for COVID-19 screening primarily based on machine learning algorithms. In our study, we used PubMed central repository and Web of Science with key words: (Cough OR Cough Sounds OR Speech) AND (Machine learning OR Deep learning OR Artificial intelligence) AND (COVID-19 OR Coronavirus). For better meta-analysis, we screened for appropriate dataset (size and source), algorithmic factors (both shallow learning and deep learning models) and corresponding performance scores. Further, in order not to miss up-to-date experimental research-based articles, we also included articles outside of PubMed and Web of Science, but pre-print articles were strictly avoided as they are not peer-reviewed.

SpeechSpiro: Lung Function Assessment from Speech Pattern as an Alternative to Spirometry for Mobile Health Tracking

Respiratory illnesses are common in the United States and globally; people deal with these illnesses in various forms, such as asthma, chronic obstructive pulmonary diseases, or infectious respiratory diseases (e.g., coronavirus). The lung function of subjects affected by these illnesses degrades due to infection or inflammation in their respiratory airways. Typically, lung function is assessed using in-clinic medical equipment, and quite recently, via portable spirometry devices. Research has shown that the obstruction and restriction in the respiratory airways affect individuals' voice characteristics. Hence, audio features could play a role in predicting the lung function and severity of the obstruction. In this paper, we go beyond well-known voice audio features and create a hybrid deep learning model using CNN-LSTM to discover spatiotemporal patterns in speech and predict the lung function parameters with accuracy comparable to conventional devices. We validate the performance and generalizability of our method using the data collected from 201 subjects enrolled in two studies internally and in collaboration with a pulmonary hospital. SpeechSpiro measures lung function parameters (e.g., forced vital capacity) with a mean normalized RMSE of 12% and R² score of up to 76% using 60-second phone audio recordings of individuals reading a passage.Clinical relevance - Speech-based spirometry has the potential to eliminate the need for an additional device to carry out the lung function assessment outside clinical settings; hence, it can enable continuous and mobile track of the individual's condition, healthy or with a respiratory illness, using a smartphone.

Device Invariant Deep Neural Networks for Pulmonary Audio Event Detection Across Mobile and Wearable Devices

Mobile and wearable devices are being increasingly used for developing audio based machine learning models to infer pulmonary health, exacerbation and activity. A major challenge to widespread usage and deployment of such pulmonary health monitoring audio models is to maintain accuracy and robustness across a variety of commodity devices, due to the effect of device heterogeneity. Because of this phenomenon, pulmonary audio models developed with data from one type of device perform poorly when deployed on another type of device. In this work, we propose a framework incorporating feature normalization across individual frequency bins and combining task specific deep neural networks for model invariance across devices for pulmonary event detection. Our empirical and extensive experiments with data from 131 real pulmonary patients and healthy controls show that our framework can recover up to 163.6% of the accuracy lost due to device heterogeneity for four different pulmonary classification tasks across two broad classification scenarios with two common mobile and wearable devices: smartphone and smartwatch.Clinical relevance- The methods presented in this paper will enable efficient and easy portability of clinician recommended pulmonary audio event detection and analytic models across various mobile and wearable devices used by a patient.

A Novel Multi-Centroid Template Matching Algorithm and Its Application to Cough Detection

Cough is a major symptom of respiratory-related diseases. There exists a tremendous amount of work in detecting coughs from audio but there has been no effort to identify coughs from solely inertial measurement unit (IMU). Coughing causes motion across the whole body and especially on the neck and head. Therefore, head motion data during coughing captured by a head-worn IMU sensor could be leveraged to detect coughs using a template matching algorithm. In time series template matching problems, K-Nearest Neighbors (KNN) combined with elastic distance measurement (esp. Dynamic Time Warping (DTW)) achieves outstanding performance. However, it is often regarded as prohibitively time-consuming. Nearest Centroid Classifier is thereafter proposed. But the accuracy is comprised of only one centroid obtained for each class. Centroid-based Classifier performs clustering and averaging for each cluster, but requires manually setting the number of clusters. We propose a novel self-tuning multi-centroid template-matching algorithm, which can automatically adjust the number of clusters to balance accuracy and inference time. Through experiments conducted on synthetic datasets and a real-world earbud-based cough dataset, we demonstrate the superiority of our proposed algorithm and present the result of cough detection with a single accelerometer sensor on the earbuds platform.Clinical relevance- Coughing is a ubiquitous symptom of pulmonary disease, especially for patients with COPD and asthma. This work explores the possibility and and presents the result of cough detection using an IMU sensor embedded in earables.