Using Machine Learning and a Combination of Respiratory Flow, Laryngeal Motion, and Swallowing Sounds to Classify Safe and Unsafe Swallowing

<italic>Objective:</italic> The aim of this research was to develop a swallowing assessment method to help prevent aspiration pneumonia. The method uses simple sensors to monitor swallowing function during an individual's daily life. <italic>Methods:</italic> The key characteristics of our proposed method are as follows. First, we assess swallowing function by using respiratory flow, laryngeal motion, and swallowing sound signals recorded by simple sensors. Second, we classify whether the recorded signals correspond to healthy subjects or patients with dysphagia. Finally, we analyze the recorded signals using both a feature extraction method (linear predictive coding) and a machine learning method (support vector machine). <italic>Results:</italic> Based on our experimental results for 140 healthy subjects (54.5 <inline-formula><tex-math notation="LaTeX">$ \pm $</tex-math></inline-formula> 32.5 years old) and 52 patients with dysphagia (75.5 <inline-formula><tex-math notation="LaTeX">$ \pm $</tex-math></inline-formula> 20.5 years old), our proposed method could achieve 82.4% sensitivity and 86.0% specificity. <italic>Conclusion:</italic> Although 20% of testing sample sets were erroneously classified, we conclude that our proposed method may facilitate screening examinations of swallowing function. <italic>Significance:</italic> In combination with the portable sensors, our proposed method is worth utilizing for noninvasive swallowing assessment.

[1]  Chih-Jen Lin,et al.  LIBSVM: A library for support vector machines , 2011, TIST.

[2]  JoAnne Robbins,et al.  Test-retest variability in normal swallowing , 1990, Dysphagia.

[3]  T. Morita,et al.  Reliability and validity of a tool to measure the severity of dysphagia: the Food Intake LEVEL Scale. , 2013, Journal of pain and symptom management.

[4]  Michael R. Neuman,et al.  Automatic Detection of Swallowing Events by Acoustical Means for Applications of Monitoring of Ingestive Behavior , 2010, IEEE Transactions on Biomedical Engineering.

[5]  Ryosuke Takahashi,et al.  Swallow-monitoring system with acoustic analysis for dysphagia , 2014, 2014 IEEE International Conference on Systems, Man, and Cybernetics (SMC).

[6]  W. Fan,et al.  Effectiveness of Neuromuscular Electrical Stimulation on Patients With Dysphagia With Medullary Infarction. , 2016, Archives of physical medicine and rehabilitation.

[7]  Tobi Frymark,et al.  Screening Accuracy for Aspiration Using Bedside Water Swallow Tests: A Systematic Review and Meta-Analysis. , 2016, Chest.

[8]  Maurizio Ranieri,et al.  Acoustic analysis of swallowing sounds: a new technique for assessing dysphagia. , 2009, Journal of rehabilitation medicine.

[9]  Toru Yabe,et al.  A noninvasive swallowing measurement system using a combination of respiratory flow, swallowing sound, and laryngeal motion , 2016, Medical & Biological Engineering & Computing.

[10]  J. Makhoul,et al.  Linear prediction: A tutorial review , 1975, Proceedings of the IEEE.

[11]  Z. Moussavi,et al.  Automated classification of swallowing and breadth sounds , 2004, The 26th Annual International Conference of the IEEE Engineering in Medicine and Biology Society.

[12]  Tom Chau,et al.  Automatic discrimination between safe and unsafe swallowing using a reputation-based classifier , 2011, Biomedical engineering online.

[13]  Tom Chau,et al.  Effects of Age and Stimulus on Submental Mechanomyography Signals During Swallowing , 2009, Dysphagia.

[14]  Zahra Moussavi,et al.  Characteristics of the swallowing sounds recorded in the ear, nose and on trachea , 2012, Medical & Biological Engineering & Computing.

[15]  Wann-Yun Shieh,et al.  Development of a Portable Non-Invasive Swallowing and Respiration Assessment Device † , 2015, Sensors.

[16]  Tom Chau,et al.  Quantitative classification of pediatric swallowing through accelerometry , 2012, Journal of NeuroEngineering and Rehabilitation.

[17]  P. Belafsky,et al.  Validity and Reliability of the Eating Assessment Tool (EAT-10) , 2008, The Annals of otology, rhinology, and laryngology.

[18]  Peyman Adibi,et al.  Automated Acoustic Analysis in Detection of Spontaneous Swallows in Parkinson’s Disease , 2014, Dysphagia.

[19]  Michael A. Crary,et al.  Validation and Demonstration of an Isolated Acoustic Recording Technique to Estimate Spontaneous Swallow Frequency , 2013, Dysphagia.

[20]  Tomoyuki Ueno,et al.  Smartphone-Based Real-time Assessment of Swallowing Ability From the Swallowing Sound , 2015, IEEE Journal of Translational Engineering in Health and Medicine.

[21]  Bonnie Martin-Harris,et al.  Breathing and swallowing dynamics across the adult lifespan. , 2005, Archives of otolaryngology--head & neck surgery.

[22]  戸原 玄 Three tests for predicting aspiration without videofluorography , 2002 .

[23]  K. Domen,et al.  Inappropriate Timing of Swallow in the Respiratory Cycle Causes Breathing–Swallowing Discoordination , 2017, Front. Physiol..

[24]  Zahra Moussavi,et al.  Detection of swallows with silent aspiration using swallowing and breath sound analysis , 2012, Medical & Biological Engineering & Computing.

[25]  Y. Oku,et al.  Coordination between respiration and swallowing during non‐invasive positive pressure ventilation , 2016, Respirology.