Integrated Approach for Automatic Crackle Detection Based on Fractal Dimension and Box Filtering

Crackles are adventitious respiratory sounds RS that provide valuable information on different respiratory conditions. Nevertheless, crackles automatic detection in RS is challenging, mainly when collected in clinical settings. This study aimed to develop an algorithm for automatic crackle detection/characterisation and to evaluate its performance and accuracy against a multi-annotator gold standard. The algorithm is based on 4 main procedures: i recognition of a potential crackle; ii verification of its validity; iii characterisation of crackles parameters; and iv optimisation of the algorithm parameters. Twenty-four RS files acquired in clinical settings were selected from 10 patients with pneumonia and cystic fibrosis. The algorithm performance was assessed by comparing its results with a multi-annotator gold standard agreement. High level of overall performance F-score=92% was achieved. The results highlight the potential of the algorithm for automatic crackle detection and characterisation of RS acquired in clinical settings.

[1]  Gwo-Ching Chang,et al.  Performance evaluation and enhancement of lung sound recognition system in two real noisy environments , 2010, Comput. Methods Programs Biomed..

[2]  P Piirilä,et al.  Changes in crackle characteristics during the clinical course of pneumonia. , 1992, Chest.

[3]  Anna Barney,et al.  Clinically useful outcome measures for physiotherapy airway clearance techniques: a review , 2006 .

[4]  Tom Fawcett,et al.  An introduction to ROC analysis , 2006, Pattern Recognit. Lett..

[5]  Wei Shen,et al.  Sum-box technique for fast linear filtering , 2002, Signal Process..

[6]  L Vannuccini,et al.  A new method to detect crackles in respiratory sounds. , 1998, Technology and health care : official journal of the European Society for Engineering and Medicine.

[7]  Guilherme Campos,et al.  Respiratory Sound Annotation Software , 2018, HEALTHINF.

[8]  F. Dalmasso,et al.  Definition of terms for applications of respiratory sounds , 2000 .

[9]  Stephen R. Gulliver,et al.  Patient safety and quality care through health informatics , 2014 .

[10]  A. Akbaş,et al.  Designing a Microcontroller-Based Portable MMC/SD Card Recorder: Time and Frequency Domain Analysis of HRV Using Sequential Interbeat Times , 2010 .

[11]  George Hripcsak,et al.  Technical Brief: Agreement, the F-Measure, and Reliability in Information Retrieval , 2005, J. Am. Medical Informatics Assoc..

[12]  Yannis A. Tolias,et al.  An orthogonal least squares-based fuzzy filter for real-time analysis of lung sounds , 2000, IEEE Transactions on Biomedical Engineering.

[13]  D. Bates,et al.  Clinical Decision Support Systems , 1999, Health Informatics.

[14]  Leontios J. Hadjileontiadis,et al.  Wheeze detection based on time-frequency analysis of breath sounds , 2007, Comput. Biol. Medicine.

[15]  Tor-Morten Grønli,et al.  Towards Interactive Virtual Environments through Handheld Devices for the Disabled: A Performance-Evaluation Perspective , 2014 .

[16]  Ana Oliveira,et al.  Respiratory sounds in healthy people: a systematic review. , 2014, Respiratory medicine.

[17]  D. Brooks,et al.  Interrater reliability of auscultation of breath sounds among physical therapists. , 1995, Physical therapy.

[18]  P D Welsby,et al.  Some high pitched thoughts on chest examination , 2001, Postgraduate medical journal.

[19]  H. Harashima,et al.  Separation of fine crackles from vesicular sounds by a nonlinear digital filter , 1989, IEEE Transactions on Biomedical Engineering.

[20]  Mehmet Fatih Akay,et al.  Support vector machines combined with feature selection for breast cancer diagnosis , 2009, Expert Syst. Appl..

[21]  W. V. Lerberghe,et al.  The World Health Report 2008 Primary Health Care – Now More Than Ever 100 Adapting reforms to country context , 2008 .

[22]  M Nissan,et al.  Respiratory health screening using pulmonary function tests and lung sound analysis. , 1994, The European respiratory journal.

[23]  Guilherme Campos,et al.  Multi-algorithm Respiratory Crackle Detection , 2013, HEALTHINF.

[24]  Tom Fawcett,et al.  ROC Graphs: Notes and Practical Considerations for Researchers , 2007 .

[25]  Carlos Sevcik,et al.  A procedure to Estimate the Fractal Dimension of Waveforms , 2010, 1003.5266.

[26]  L.J. Hadjileontiadis,et al.  Multimedia database "Marburg Respiratory Sounds (MARS)" , 2003, Proceedings of the 25th Annual International Conference of the IEEE Engineering in Medicine and Biology Society (IEEE Cat. No.03CH37439).

[27]  Anna Barney,et al.  The reliability of lung crackle characteristics in cystic fibrosis and bronchiectasis patients in a clinical setting , 2009, Physiological measurement.

[28]  Mohammed Bahoura,et al.  An integrated automated system for crackles extraction and classification , 2008, Biomed. Signal Process. Control..

[29]  R. Murphy,et al.  Validation of an automatic crackle (rale) counter. , 1989, The American review of respiratory disease.

[30]  L.J. Hadjileontiadis,et al.  Detection of explosive lung and bowel sounds by means of fractal dimension , 2003, IEEE Signal Processing Letters.

[31]  S. Haltsonen,et al.  Validated method for automatic detection of lung sound crackles , 1991, Medical and Biological Engineering and Computing.

[32]  Stavros M. Panas,et al.  Nonlinear separation of crackles and squawks from vesicular sounds using third-order statistics , 1996, Proceedings of 18th Annual International Conference of the IEEE Engineering in Medicine and Biology Society.

[33]  S. Jenkins,et al.  Accuracy and reliability of physiotherapists in the interpretation of tape-recorded lung sounds. , 1995, The Australian journal of physiotherapy.

[34]  M. Cruz-cunha,et al.  Handbook of Research on Developments in E-health and Telemedicine: Technological and Social Perspectives , 2009 .

[35]  João Dinis,et al.  Automatic Wheeze Detection and Lung Function Evaluation - A Preliminary Study , 2013, HEALTHINF.

[36]  M. J. Katz,et al.  Fractals and the analysis of waveforms. , 1988, Computers in biology and medicine.

[37]  A. Bohadana,et al.  Fundamentals of lung auscultation. , 2014, The New England journal of medicine.

[38]  E. Shortliffe Clinical decision-support systems , 1990 .

[39]  Stan Szpakowicz,et al.  Beyond Accuracy, F-Score and ROC: A Family of Discriminant Measures for Performance Evaluation , 2006, Australian Conference on Artificial Intelligence.