Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2020 Sep 29;21(1):253.
doi: 10.1186/s12931-020-01523-9.

Artificial intelligence accuracy in detecting pathological breath sounds in children using digital stethoscopes

Affiliations

Artificial intelligence accuracy in detecting pathological breath sounds in children using digital stethoscopes

Ajay Kevat et al. Respir Res. .

Abstract

Background: Manual auscultation to detect abnormal breath sounds has poor inter-observer reliability. Digital stethoscopes with artificial intelligence (AI) could improve reliable detection of these sounds. We aimed to independently test the abilities of AI developed for this purpose.

Methods: One hundred and ninety two auscultation recordings collected from children using two different digital stethoscopes (Clinicloud™ and Littman™) were each tagged as containing wheezes, crackles or neither by a pediatric respiratory physician, based on audio playback and careful spectrogram and waveform analysis, with a subset validated by a blinded second clinician. These recordings were submitted for analysis by a blinded AI algorithm (StethoMe AI) specifically trained to detect pathologic pediatric breath sounds.

Results: With optimized AI detection thresholds, crackle detection positive percent agreement (PPA) was 0.95 and negative percent agreement (NPA) was 0.99 for Clinicloud recordings; for Littman-collected sounds PPA was 0.82 and NPA was 0.96. Wheeze detection PPA and NPA were 0.90 and 0.97 respectively (Clinicloud auscultation), with PPA 0.80 and NPA 0.95 for Littman recordings.

Conclusions: AI can detect crackles and wheeze with a reasonably high degree of accuracy from breath sounds obtained from different digital stethoscope devices, although some device-dependent differences do exist.

Keywords: Artificial intelligence; Auscultation; Child; Respiratory sounds; Stethoscopes.

PubMed Disclaimer

Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Participant recruitment and recording analysis flowchart
Fig. 2
Fig. 2
Receiver Operating Characteristic (ROC) Curve: AI performance in detecting. Clinicloud-recorded wheeze
Fig. 3
Fig. 3
Receiver Operating Characteristic (ROC) Curve: AI performance in detecting. Clinicloud-recorded crackles
Fig. 4
Fig. 4
Receiver Operating Characteristic (ROC) Curve: AI performance in detecting. Littman-recorded wheeze
Fig. 5
Fig. 5
Receiver Operating Characteristic (ROC) Curve: AI performance in detecting. Littman-recorded crackles

References

    1. Wipf JE, Lipsky BA, Hirschmann JV, Boyko EJ, Takasugi J, Peugeot RL, et al. Diagnosing pneumonia by physical examination. Arch Intern Med. 1999;159(10):1082–1087. doi: 10.1001/archinte.159.10.1082. - DOI - PubMed
    1. Brooks D, Thomas J. Interrater reliability of auscultation of breath sounds among physical therapists. Phys Ther. 1995;75(12):1082–1088. doi: 10.1093/ptj/75.12.1082. - DOI - PubMed
    1. Prodhan P, Dela Rosa RS, Shubina M, Haver KE, Matthews BD, Buck S, et al. Wheeze detection in the pediatric intensive care unit: comparison among physician, nurses, respiratory therapists, and a computerized respiratory sound monitor. Respir Care. 2008;53:1304–1309. - PubMed
    1. Ramanathan A, Zhou L, Marzbanrad F, Roseby R, Tan K, Kevat A, et al. Digital stethoscopes in paediatric medicine. Acta Paediatr. 2019;108(5):814–822. doi: 10.1111/apa.14686. - DOI - PubMed
    1. Aviles-Solis JC, Vanbelle S, Halvorsen PA, Francis N, Cals JWL, Andreeva EA, et al. International perception of lung sounds: a comparison of classification across some European borders. BMJ Open Respir Res. 2017;4(1):e000250. doi: 10.1136/bmjresp-2017-000250. - DOI - PMC - PubMed