Differentiating Productive and Nonproductive Cough using Cough Acoustics & Machine Learning

R. Pathri, Shekhar Jha
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Abstract

A wet cough by definition is when the cough brings about mucous in the phlegm due an irritant or an inflammation in the Lungs. Every cough regardless of it being wet or dry brings about phlegm and the degree of mucous varies and is much more in quantity in cases of a wet cough & can be used to determine the extent of SOB (shortness of breath), dyspnea due to excessive mucous. This is not always the case in that there are instances where the dry cough subjects may also experience dyspnea that can be attributed to other underlying & related conditions. From an acoustics perspective, a dry cough is usually something like a bland and hacking sound that is followed by an irritation in the Lungs while wet cough has a certain tonality to it whether it is crackling or a rattling sound. Tonality here can be measured using Spectral Flatness & other spectral variables that provide explainability are kurtosis, spectral centroid and spectral skewness. While this is not an exhaustive list, there are other variables that or of importance. Mucous is agnostic to whether it is a bacterial or viral infection but with Pneumonia, there are some indicators with sticky mucous with a bacterial infection Vs viral. However, an indicator of dyspnea induced by phlegm and whether it can differentiate between a bacterial and a viral Pneumonia is an important use case, the later in this context. Wet cough with wheezing caught at an early stage can determine an underlying Emphysema condition [1]. Emphysema: Types, Symptoms, Causes, Diagnosis, Treatment (health.com) or other forms of COPD such as chronic Bronchitis. Cystic Fibrosis has a certain type of mucous that if screened early can be priceless. The shortness of breath caused due to excessive mucus in the Phlegm, if it can rule out Lung Cancer as a screening modality are other areas where the applicability of wet cough can be useful. While the applications are many, in this paper we discuss the AI/ML methods on the acoustics of the “wetness or dryness” of a cough which provides an additional biomarker under the primary biomarker, “cough” in the field of acoustic epidemiology
使用咳嗽声学和机器学习区分生产性和非生产性咳嗽
湿性咳嗽的定义是由于肺部的刺激或炎症导致痰中有粘液。每次咳嗽,无论是湿咳还是干咳,都会产生痰,粘液的程度各不相同,湿咳的数量更多,可以用来确定SOB(呼吸短促)的程度,由于粘液过多而导致的呼吸困难。但情况并非总是如此,因为在某些情况下,干咳患者也可能经历呼吸困难,这可能归因于其他潜在和相关条件。从声学的角度来看,干咳通常是一种平淡而刺耳的声音,随后是肺部的刺激,而湿咳则有一定的调性,无论是噼啪声还是嘎嘎声。这里的调性可以用光谱平坦度来测量,其他提供可解释性的光谱变量是峰度、光谱质心和光谱偏度。虽然这不是一个详尽的列表,但还有其他重要的变量。黏液对于是细菌感染还是病毒感染是不可知的,但对于肺炎,黏液有一些指标与细菌感染Vs病毒感染有关。然而,痰引起的呼吸困难的指标以及它是否可以区分细菌性和病毒性肺炎是一个重要的用例,后者在本文中是后者。早期湿咳伴喘息可确定潜在的肺气肿状况[1]。肺气肿:类型,症状,原因,诊断,治疗(health.com)或其他形式的慢性阻塞性肺病,如慢性支气管炎。囊性纤维化有一种特定类型的粘液,如果及早筛查可能是无价之宝。由于痰中粘液过多而引起的呼吸短促,如果能排除肺癌作为筛查方式,则湿咳法在其他领域的适用性也能发挥作用。虽然应用很多,但在本文中,我们讨论了关于咳嗽“湿或干”声学的AI/ML方法,它在声学流行病学领域的主要生物标志物“咳嗽”下提供了额外的生物标志物
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