A study protocol for community use of digital auscultation to improve diagnosis of paediatric pneumonia in Bangladesh

The World Health Organisation Integrated Management of Childhood Illnesses (IMCI) algorithm relies on counting respiratory rate and observing respiratory distress to diagnose childhood pneumonia. IMCI performs with high sensitivity but low specificity, leading to over-diagnosis of child pneumonia and unnecessary antibiotic use. Including lung auscultation in IMCI could improve pneumonia diagnosis. Our objectives are: (i) assess lung sound recording quality by primary health care workers (HCWs) from under-five children with the Feelix Smart Stethoscope; and (ii) determine the reliability and performance of recorded lung sound interpretations by an automated algorithm compared to reference paediatrician interpretations. In a cross-sectional design, Community HCWs will record lung sounds of 1,003 under-five-year-old children with suspected pneumonia at first-level facilities in Zakiganj sub-district, Sylhet, Bangladesh. Enrolled children will be evaluated for pneumonia, including oxygen saturation, and have their lung sounds recorded by the Feelix Smart stethoscope at four sequential chest locations: two back and two front positions. A novel sound-filtering algorithm will be applied to recordings to address ambient noise and optimize recording quality. Recorded sounds will be assessed against a pre-defined quality threshold. A trained paediatric listening panel will classify recordings into one of the following categories: normal, crackle, wheeze, crackle and wheeze, or uninterpretable. All sound files will be classified into the same categories by the automated algorithm and compared with panel classifications. Lung auscultation and reliable interpretation of lung sounds of children are usually not feasible in first-level facilities in Bangladesh and other low- and middle-income countries (LMICs). Incorporating automated lung sound classification within the current IMCI pneumonia diagnostic algorithm may improve childhood pneumonia diagnostic accuracy at LMIC first-level facilities.

Classification of Lung Sounds and Disease Prediction using Dense CNN Network

Respiratory illnesses are a main source of death in the world and exact lung sound identification is very significant for the conclusion and assessment of sickness. Be that as it may, this method is vulnerable to doctors and instrument limitations. As a result, the automated investigation and analysis of respiratory sounds has been a field of great research and exploration during the last decades. The classification of respiratory sounds has the potential to distinguish anomalies and diseases in the beginning phases of a respiratory dysfunction and hence improve the accuracy of decision making. In this paper, we explore the publically available respiratory sound database and deploy three different convolutional neural networks (CNN) and combine them to form a dense network to diagnose the respiratory disorders. The results demonstrate that this dense network classifies the sounds accurately and diagnoses the corresponding respiratory disorders associated with them.

Multi-channel lung sounds intelligent diagnosis of chronic obstructive pulmonary disease

Background Chronic obstructive pulmonary disease (COPD) is a chronic respiratory disease that seriously threatens people’s health, with high morbidity and mortality worldwide. At present, the clinical diagnosis methods of COPD are time-consuming, invasive, and radioactive. Therefore, it is urgent to develop a non-invasive and rapid COPD severity diagnosis technique suitable for daily screening in clinical practice. Results This study established an effective model for the preliminary diagnosis of COPD severity using lung sounds with few channels. Firstly, the time-frequency-energy features of 12 channels lung sounds were extracted by Hilbert–Huang transform. And then, channels and features were screened by the reliefF algorithm. Finally, the feature sets were input into a support vector machine to diagnose COPD severity, and the performance with Bayes, decision tree, and deep belief network was compared. Experimental results show that high classification performance using only 4-channel lung sounds of L1, L2, L3, and L4 channels can be achieved by the proposed model. The accuracy, sensitivity, and specificity of mild COPD and moderate + severe COPD were 89.13%, 87.72%, and 91.01%, respectively. The classification performance rates of moderate COPD and severe COPD were 94.26%, 97.32%, and 89.93% for accuracy, sensitivity, and specificity, respectively. Conclusion This model provides a standardized evaluation with high classification performance rates, which can assist doctors to complete the preliminary diagnosis of COPD severity immediately, and has important clinical significance.

Heart and Lung Sound Measurement Using an Esophageal Stethoscope with Adaptive Noise Cancellation

In surgeries where general anesthesia is required, the auscultation of heart and lung sounds is essential to provide information on the patient’s cardiorespiratory system. Heart and lung sounds can be recorded using an esophageal stethoscope; however, there is huge background noise when this device is used in an operating room. In this study, a digital esophageal stethoscope system was designed. A 3D-printed case filled with Polydimethylsiloxane material was designed to hold two electret-type microphones. One of the microphones was placed inside the printed case to collect the heart and lung sound signals coming out from the patient through the esophageal catheter, the other was mounted on the surface of the case to collect the operating room sounds. A developed adaptive noise canceling algorithm was implemented to remove the operating room noise corrupted with the main heart and lung sound signals and the output signal was displayed on software application developed especially for this study. Using the designed case, the noise level of the signal was reduced to some extent, and by adding the adaptive filter, further noise reduction was achieved. The designed system is lightweight and can provide noise-free heart and lung sound signals.