Automatic Croup Diagnosis Using Cough Sound Recognition

Objective: Croup, a respiratory tract infection common in children, causes an inflammation of the upper airway restricting normal breathing and producing cough sounds typically described as seallike “barking cough.” Physicians use the existence of barking cough as the defining characteristic of croup. This paper aims to develop automated cough sound analysis methods to objectively diagnose croup. Methods: In automating croup diagnosis, we propose the use of mathematical features inspired by the human auditory system. In particular, we utilize the cochleagram for feature extraction, a time-frequency representation where the frequency components are based on the frequency selectivity property of the human cochlea. Speech and cough share some similarities in the generation process and physiological wetware used. As such, we also propose the use of mel-frequency cepstral coefficients which has been shown to capture the relevant aspects of the short-term power spectrum of speech signals. Feature combination and backward sequential feature selection are also experimented with. Experimentation is performed on cough sound recordings from patients presenting various clinically diagnosed respiratory tract infections divided into croup and non-croup. The dataset is divided into training and test sets of 364 and 115 patients, respectively, with automatically segmented cough sound segments. Results: Croup and non-croup patient classification on the test dataset with the proposed methods achieve a sensitivity and specificity of 92.31% and 85.29%, respectively. Conclusion: Experimental results show the significant improvement in automatic croup diagnosis against earlier methods. Significance: This paper has the potential to automate croup diagnosis based solely on cough sound analysis.

[1]  John H. L. Hansen,et al.  Analysis of the root-cepstrum for acoustic modeling and fast decoding in speech recognition , 2001, INTERSPEECH.

[2]  Douglas D. O'Shaughnessy,et al.  Speech communication : human and machine , 1987 .

[3]  Steve Young,et al.  The HTK book version 3.4 , 2006 .

[4]  Renard Xaviero Adhi Pramono,et al.  A Cough-Based Algorithm for Automatic Diagnosis of Pertussis , 2016, PloS one.

[5]  D. D. Greenwood A cochlear frequency-position function for several species--29 years later. , 1990, The Journal of the Acoustical Society of America.

[6]  R. Patterson,et al.  Complex Sounds and Auditory Images , 1992 .

[7]  Tom J. Moir,et al.  Cochleagram image feature for improved robustness in sound recognition , 2015, 2015 IEEE International Conference on Digital Signal Processing (DSP).

[8]  David W Johnson,et al.  Croup in children , 2013, Canadian Medical Association Journal.

[9]  C. Doherty Book Review: Management of the Child with a Serious Infection or Severe Malnutrition , 2001 .

[10]  Jasper Snoek,et al.  Practical Bayesian Optimization of Machine Learning Algorithms , 2012, NIPS.

[11]  Malcolm Slaney,et al.  An Efficient Implementation of the Patterson-Holdsworth Auditory Filter Bank , 1997 .

[12]  Bernhard E. Boser,et al.  A training algorithm for optimal margin classifiers , 1992, COLT '92.

[13]  Vinayak Swarnkar,et al.  Wavelet Augmented Cough Analysis for Rapid Childhood Pneumonia Diagnosis , 2015, IEEE Transactions on Biomedical Engineering.

[14]  Geoffrey E. Hinton,et al.  Reducing the Dimensionality of Data with Neural Networks , 2006, Science.

[15]  Corinna Cortes,et al.  Support-Vector Networks , 1995, Machine Learning.

[16]  Christian Wellekens,et al.  On desensitizing the Mel-cepstrum to spurious spectral components for robust speech recognition , 2005, Proceedings. (ICASSP '05). IEEE International Conference on Acoustics, Speech, and Signal Processing, 2005..

[17]  Ross Upshur,et al.  Croup Hospitalizations in Ontario: A 14-Year Time-Series Analysis , 2005, Pediatrics.

[18]  Udantha R. Abeyratne,et al.  Cough sound analysis for diagnosing croup in pediatric patients using biologically inspired features , 2017, 2017 39th Annual International Conference of the IEEE Engineering in Medicine and Biology Society (EMBC).

[19]  Jürgen Schmidhuber,et al.  Deep learning in neural networks: An overview , 2014, Neural Networks.

[20]  David W Johnson,et al.  Croup , 2008, The Lancet.

[21]  Vinayak Swarnkar,et al.  Cough Sound Analysis Can Rapidly Diagnose Childhood Pneumonia , 2013, Annals of Biomedical Engineering.

[22]  Vinayak Swarnkar,et al.  Automatic cough segmentation from non-contact sound recordings in pediatric wards , 2015, Biomed. Signal Process. Control..