Validation of computerized wheeze detection in young infants during the first months of life

BMC Pediatrics

Gerd Schmalisch¹  Simon Godfrey³  Jakob Usemann²  Silke Wilitzki¹  Hendrik S Fischer¹  Lia C Puder¹ 

[1] Department of Neonatology, Charité University Medical Center, Berlin, Germany;Department of Pediatric Pneumology and Immunology, Charité University Medical Center, Berlin, Germany;Emeritus Professor of Pediatrics, Hadassah-Hebrew University, Jerusalem, Israel

关键词: Infants;    Computerized wheeze detection;    Wheezing;    Phonopneumography;    Auscultation;    Lung sound;   

Others  :  1121218
DOI  :  10.1186/1471-2431-14-257

 received in 2014-04-17, accepted in 2014-09-22,  发布年份 2014

【 摘 要 】

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.

【 授权许可】

   
2014 Puder et al.; licensee BioMed Central Ltd.

【 图 表 】

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