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Validation of computerized wheeze detection in young infants during the first months of life
Lia C Puder, Hendrik S Fischer, Silke Wilitzki
1Department of Neonatology, Charité University Medical Center, Berlin, Germany. gerd.schmalisch@charite.de.
Insights
Computerized wheeze detection in infants under one year is feasible. This objective method provides quantitative data on wheezing, outperforming subjective auscultation.
Area of Science:
- Pediatric respiratory medicine
- Medical acoustics
- Infant health
Background:
- Respiratory diseases in infants present unique diagnostic challenges.
- Traditional auscultation is subjective; objective, continuous lung sound analysis is needed.
- Computerized lung sound analysis has been underexplored in neonates.
Purpose of the Study:
- To determine and validate optimal cut-off values for computerized wheeze detection in infants.
- To assess the feasibility of this technology in infants under one year of age.
Main Methods:
- Lung sounds from 120 infants (<1 year) were recorded using an automatic wheeze detection device.
- Three clinicians retrospectively evaluated recordings, blinded to results.
- Receiver operating curve analysis identified optimal cut-off values for wheeze detection.
Main Results:
- Optimal cut-off values were 2% for inspiratory and 3% for expiratory wheezing.
- Sensitivity and specificity for inspiratory wheezing were 85.7% and 80.7%; for expiratory, 84.6% and 82.5%.
- Moderate inter-observer reliability was observed (Kappa 0.59 and 0.54).
Conclusions:
- Computerized wheeze detection is a viable tool for infants in their first year of life.
- This method offers objective, standardized, and quantitative assessment of wheezing.
- It provides noninvasive insights into wheezing extent, superior to subjective auscultation.
Background:
Several respiratory diseases are associated with specific respiratory sounds. In contrast to auscultation, computerized lung sound analysis is objective and can be performed continuously over an extended period. Moreover, audio recordings can be stored. Computerized lung sounds have rarely been assessed in neonates during the first year of life. This study was designed to determine and validate optimal cut-off values for computerized wheeze detection, based on the assessment by trained clinicians of stored records of lung sounds, in infants aged <1 year.
Methods:
Lung sounds in 120 sleeping infants, of median (interquartile range) postmenstrual age of 51 (44.5-67.5) weeks, were recorded on 144 test occasions by an automatic wheeze detection device (PulmoTrack®). The records were retrospectively evaluated by three trained clinicians blinded to the results. Optimal cut-off values for the automatically determined relative durations of inspiratory and expiratory wheezing were determined by receiver operating curve analysis, and sensitivity and specificity were calculated.
Results:
The optimal cut-off values for the automatically detected durations of inspiratory and expiratory wheezing were 2% and 3%, respectively. These cutoffs had a sensitivity and specificity of 85.7% and 80.7%, respectively, for inspiratory wheezing and 84.6% and 82.5%, respectively, for expiratory wheezing. Inter-observer reliability among the experts was moderate, with a Fleiss' Kappa (95% confidence interval) of 0.59 (0.57-0.62) for inspiratory and 0.54 (0.52 - 0.57) for expiratory wheezing.
Conclusion:
Computerized wheeze detection is feasible during the first year of life. This method is more objective and can be more readily standardized than subjective auscultation, providing quantitative and noninvasive information about the extent of wheezing.
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