Abstract

A reliable, remote, and continuous real-time respiratory sound monitor with automated respiratory sound analysis ability is urgently required in many clinical scenarios-such as in monitoring disease progression of coronavirus disease 2019-to replace conventional auscultation with a handheld stethoscope. However, a robust computerized respiratory sound analysis algorithm for breath phase detection and adventitious sound detection at the recording level has not yet been validated in practical applications. In this study, we developed a lung sound database (HF_Lung_V1) comprising 9,765 audio files of lung sounds (duration of 15 s each), 34,095 inhalation labels, 18,349 exhalation labels, 13,883 continuous adventitious sound (CAS) labels (comprising 8,457 wheeze labels, 686 stridor labels, and 4,740 rhonchus labels), and 15,606 discontinuous adventitious sound labels (all crackles). We conducted benchmark tests using long short-term memory (LSTM), gated recurrent unit (GRU), bidirectional LSTM (BiLSTM), bidirectional GRU (BiGRU), convolutional neural network (CNN)-LSTM, CNN-GRU, CNN-BiLSTM, and CNN-BiGRU models for breath phase detection and adventitious sound detection. We also conducted a performance comparison between the LSTM-based and GRU-based models, between unidirectional and bidirectional models, and between models with and without a CNN. The results revealed that these models exhibited adequate performance in lung sound analysis. The GRU-based models outperformed, in terms of F1 scores and areas under the receiver operating characteristic curves, the LSTM-based models in most of the defined tasks. Furthermore, all bidirectional models outperformed their unidirectional counterparts. Finally, the addition of a CNN improved the accuracy of lung sound analysis, especially in the CAS detection tasks.

Highlights

  • IntroductionClinical physicians are frequently required to examine respiratory conditions

  • Respiration is vital for the normal functioning of the human body

  • We investigated the performance of eight Recurrent neural networks (RNNs)-based models, namely long short-term memory (LSTM), gated recurrent unit (GRU), bidirectional LSTM (BiLSTM), bidirectional GRU (BiGRU), convolutional neural network (CNN)-LSTM, CNN-GRU, CNN-BiLSTM, and CNN-BiGRU, in terms of inhalation, exhalation, and adventitious sound detection

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Summary

Introduction

Clinical physicians are frequently required to examine respiratory conditions. A practitioner wearing personal protective equipment finds it difficult to perform auscultation without breaching the protection [8], which limits the use of auscultation on a patient with an airborne or droplet-transmitted pulmonary disease, such as coronavirus disease 2019 (COVID-19) [9,10,11]. To overcome the aforementioned limitations, computerized respiratory sound analysis [12] is required. A tele-auscultation system [13, 14] with automated respiratory sound analysis can be realized in the form of a mobile app or web service with proper infrastructure supports, which can facilitate remote respiratory monitoring in a clinical setting but in a homecare setting. The tele-auscultation system can greatly help during care of COVID-19 patients

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