Computerised Analysis of Telemonitored Respiratory Sounds for Predicting Acute Exacerbations of COPD

Chronic obstructive pulmonary disease (COPD) is one of the commonest causes of death in the world and poses a substantial burden on healthcare systems and patients’ quality of life. The largest component of the related healthcare costs is attributable to admissions due to acute exacerbation (AECOPD). The evidence that might support the effectiveness of the telemonitoring interventions in COPD is limited partially due to the lack of useful predictors for the early detection of AECOPD. Electronic stethoscopes and computerised analyses of respiratory sounds (CARS) techniques provide an opportunity for substantial improvement in the management of respiratory diseases. This exploratory study aimed to evaluate the feasibility of using: (a) a respiratory sensor embedded in a self-tailored housing for ageing users; (b) a telehealth framework; (c) CARS and (d) machine learning techniques for the remote early detection of the AECOPD. In a 6-month pilot study, 16 patients with COPD were equipped with a home base-station and a sensor to daily record their respiratory sounds. Principal component analysis (PCA) and a support vector machine (SVM) classifier was designed to predict AECOPD. 75.8% exacerbations were early detected with an average of 5 ± 1.9 days in advance at medical attention. The proposed method could provide support to patients, physicians and healthcare systems.

[1]  Semra Içer,et al.  Classification and analysis of non-stationary characteristics of crackle and rhonchus lung adventitious sounds , 2014, Digit. Signal Process..

[2]  Andrew Robinson,et al.  Clinical diaries in COPD: compliance and utility in predicting acute exacerbations , 2012, International journal of chronic obstructive pulmonary disease.

[3]  Daniel Sánchez Morillo,et al.  Computerized analysis of respiratory sounds during COPD exacerbations , 2013, Comput. Biol. Medicine.

[4]  Zahra Moussavi,et al.  Qualitative and quantitative evaluation of heart sound reduction from lung sound recordings , 2005, IEEE Transactions on Biomedical Engineering.

[5]  Rigoberto Pérez de Alejo,et al.  Monitoring breathing rate at home allows early identification of COPD exacerbations. , 2012, Chest.

[6]  J. Wedzicha,et al.  Strategies for improving outcomes of COPD exacerbations , 2006, International journal of chronic obstructive pulmonary disease.

[7]  R. Cattell The Scree Test For The Number Of Factors. , 1966, Multivariate behavioral research.

[8]  M. Naghavi,et al.  Global and regional trends in mortality from chronic obstructive pulmonary disease: Their relation to poverty, smoking and population change , 2014 .

[9]  Yuming Guo,et al.  Calculate excess mortality during heatwaves using Hilbert-Huang transform algorithm , 2014, BMC Medical Research Methodology.

[10]  B. McKinstry,et al.  The use of remote monitoring technologies in managing chronic obstructive pulmonary disease. , 2013, QJM : monthly journal of the Association of Physicians.

[11]  John R Hurst,et al.  Structural and functional co-conspirators in chronic obstructive pulmonary disease exacerbations. , 2007, Proceedings of the American Thoracic Society.

[12]  Martin Knapp,et al.  Exploring barriers to participation and adoption of telehealth and telecare within the Whole System Demonstrator trial: a qualitative study , 2012, BMC Health Services Research.

[13]  S. Tucker,et al.  Classification of transient sonar sounds using perceptually motivated features , 2005, IEEE Journal of Oceanic Engineering.

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

[15]  B. Celli,et al.  Exacerbations of chronic obstructive pulmonary disease , 2007, European Respiratory Journal.

[16]  C. Lenfant,et al.  Global Initiative for chronic obstructive lung disease. Global strategy for the diagnosis, management and prevention of chronic obstructive pulmonary disease , 2006 .

[17]  Antti Eronen,et al.  Comparison of features for musical instrument recognition , 2001, Proceedings of the 2001 IEEE Workshop on the Applications of Signal Processing to Audio and Acoustics (Cat. No.01TH8575).

[18]  Bülent Bolat,et al.  Classification of Classic Turkish Music Makams , 2014, 2014 IEEE International Symposium on Innovations in Intelligent Systems and Applications (INISTA) Proceedings.

[19]  Kun-Ming Yu,et al.  Fusion of Static and Transitional Information of Cepstral and Spectral Features for Music Genre Classification , 2008, 2008 IEEE Asia-Pacific Services Computing Conference.

[20]  T. Seemungal,et al.  Time course and recovery of exacerbations in patients with chronic obstructive pulmonary disease. , 2000, American journal of respiratory and critical care medicine.

[21]  A. Sheikh,et al.  Effectiveness of telemonitoring integrated into existing clinical services on hospital admission for exacerbation of chronic obstructive pulmonary disease: researcher blind, multicentre, randomised controlled trial , 2013, BMJ.

[22]  D. Mannino,et al.  The epidemiology and economics of chronic obstructive pulmonary disease. , 2007, Proceedings of the American Thoracic Society.

[23]  T. Seemungal,et al.  Early therapy improves outcomes of exacerbations of chronic obstructive pulmonary disease. , 2004, American journal of respiratory and critical care medicine.

[24]  R. Pauwels,et al.  Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease. NHLBI/WHO Global Initiative for Chronic Obstructive Lung Disease (GOLD) Workshop summary. , 2001, American journal of respiratory and critical care medicine.

[25]  P. Calverley,et al.  Seasonality and determinants of moderate and severe COPD exacerbations in the TORCH study , 2011, European Respiratory Journal.

[26]  Sirinee Thongpanja,et al.  Mean and Median Frequency of EMG Signal to Determine Muscle Force based on Time- dependent Power Spectrum , 2013 .

[27]  F. S. Tsai Comparative Study of Dimensionality Reduction Techniques for Data Visualization , 2010 .

[28]  Amjad Hashemi,et al.  Classification of Wheeze Sounds Using Wavelets and Neural Networks , 2022 .

[29]  H. Kaiser The Application of Electronic Computers to Factor Analysis , 1960 .

[30]  J. Bourbeau,et al.  Underreporting exacerbation of chronic obstructive pulmonary disease in a longitudinal cohort. , 2008, American journal of respiratory and critical care medicine.

[31]  Paul Jones,et al.  COPD uncovered: an international survey on the impact of chronic obstructive pulmonary disease [COPD] on a working age population , 2011, BMC public health.

[32]  John R Hurst,et al.  Domiciliary pulse-oximetry at exacerbation of chronic obstructive pulmonary disease: prospective pilot study , 2010, BMC pulmonary medicine.

[33]  Kenneth Sundaraj,et al.  A comparative study of the svm and k-nn machine learning algorithms for the diagnosis of respiratory pathologies using pulmonary acoustic signals , 2014, BMC Bioinformatics.

[34]  Heng Tao Shen,et al.  Principal Component Analysis , 2009, Encyclopedia of Biometrics.

[35]  N. Malmurugan,et al.  Neural classification of lung sounds using wavelet coefficients , 2004, Comput. Biol. Medicine.

[36]  Nigel H. Lovell,et al.  Predicting the risk of exacerbation in patients with chronic obstructive pulmonary disease using home telehealth measurement data , 2015, Artif. Intell. Medicine.

[37]  B. McKinstry,et al.  Changes in telemonitored physiological variables and symptoms prior to exacerbations of chronic obstructive pulmonary disease , 2015, Journal of telemedicine and telecare.

[38]  L. F. Crespo,et al.  Automatic prediction of chronic obstructive pulmonary disease exacerbations through home telemonitoring of symptoms. , 2014, Bio-medical materials and engineering.

[39]  J. Wedzicha,et al.  Detection and severity grading of COPD exacerbations using the exacerbations of chronic pulmonary disease tool (EXACT) , 2013, European Respiratory Journal.

[40]  A. Vyshedskiy,et al.  Sound transmission in the lung as a function of lung volume. , 2002, Journal of applied physiology.

[41]  I. D. Johnston,et al.  Auscultation in the diagnosis of respiratory disease in the 21st century , 2008, Postgraduate Medical Journal.

[42]  D. Mannino,et al.  Global burden of COPD: systematic review and meta-analysis , 2006, European Respiratory Journal.

[43]  Antonio León,et al.  A novel multimodal tool for telemonitoring patients with COPD , 2015, Informatics for health & social care.

[44]  N. Huang,et al.  The empirical mode decomposition and the Hilbert spectrum for nonlinear and non-stationary time series analysis , 1998, Proceedings of the Royal Society of London. Series A: Mathematical, Physical and Engineering Sciences.

[45]  A. Swensen,et al.  The Economic Impact of Exacerbations of Chronic Obstructive Pulmonary Disease and Exacerbation Definition: A Review , 2010, COPD.

[46]  Birthe Dinesen,et al.  Moving prediction of exacerbation in chronic obstructive pulmonary disease for patients in telecare , 2012, Journal of telemedicine and telecare.

[47]  Kenneth Sundaraj,et al.  Computer-based Respiratory Sound Analysis: A Systematic Review , 2013 .

[48]  Claudio Pedone,et al.  Efficacy of multiparametric telemonitoring on respiratory outcomes in elderly people with COPD: a randomized controlled trial , 2013, BMC Health Services Research.

[49]  Cristina Jácome,et al.  Computerized Respiratory Sounds in Patients with COPD: A Systematic Review , 2015, COPD.

[50]  F. Martinez,et al.  Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease: GOLD executive summary. , 2007, American journal of respiratory and critical care medicine.

[51]  Carmelo Velardo,et al.  Using A Mobile Health Application To Support Self-Management In COPD - Development Of Alert Thresholds Derived From Variability In Self-Reported And Measured Clinical Variables , 2014 .

[52]  Daniel Sánchez Morillo,et al.  Detecting COPD exacerbations early using daily telemonitoring of symptoms and k-means clustering: a pilot study , 2015, Medical & Biological Engineering & Computing.

[53]  Leontios J. Hadjileontiadis,et al.  Lung Sounds: An Advanced Signal Processing Perspective , 2008, Lung Sounds.

[54]  R. Rodríguez-Roisín,et al.  Toward a consensus definition for COPD exacerbations. , 2000, Chest.

[55]  R. Greenwood,et al.  Remote daily real-time monitoring in patients with COPD --a feasibility study using a novel device. , 2009, Respiratory medicine.

[56]  D. S. Morillo,et al.  Computer-aided diagnosis of pneumonia in patients with chronic obstructive pulmonary disease. , 2013, Journal of the American Medical Informatics Association : JAMIA.

[57]  A. Marques,et al.  Computerized Respiratory Sounds Are a Reliable Marker in Subjects With COPD , 2015, Respiratory Care.