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. 2021 Jul 2;4(1):107.
doi: 10.1038/s41746-021-00472-x.

Identifying acute exacerbations of chronic obstructive pulmonary disease using patient-reported symptoms and cough feature analysis

Scott Claxton  1   2 , Paul Porter  3   4   5 , Joanna Brisbane  1   6 , Natasha Bear  7 , Javan Wood  8 , Vesa Peltonen  8 , Phillip Della  9 , Claire Smith  1   6 , Udantha Abeyratne  8   10
Affiliations

Identifying acute exacerbations of chronic obstructive pulmonary disease using patient-reported symptoms and cough feature analysis

Scott Claxton et al. NPJ Digit Med. .

Abstract

Acute exacerbations of chronic obstructive pulmonary disease (AECOPD) are commonly encountered in the primary care setting, though the accurate and timely diagnosis is problematic. Using technology like that employed in speech recognition technology, we developed a smartphone-based algorithm for rapid and accurate diagnosis of AECOPD. The algorithm incorporates patient-reported features (age, fever, and new cough), audio data from five coughs and can be deployed by novice users. We compared the accuracy of the algorithm to expert clinical assessment. In patients with known COPD, the algorithm correctly identified the presence of AECOPD in 82.6% (95% CI: 72.9-89.9%) of subjects (n = 86). The absence of AECOPD was correctly identified in 91.0% (95% CI: 82.4-96.3%) of individuals (n = 78). The diagnostic agreement was maintained in milder cases of AECOPD (PPA: 79.2%, 95% CI: 68.0-87.8%), who typically comprise the cohort presenting to primary care. The algorithm may aid early identification of AECOPD and be incorporated in patient self-management plans.

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Conflict of interest statement

ResApp Health provided funding to support the Breathe Easy Program at JHC and UQ. Joondalup Health Campus provided office space, IT services, and consumables in kind. P.P., S.C. and U.A. are scientific advisors of ResApp Health (RAP). P.P. and U.A. are shareholders in RAP. U.A. was RAP’s Chief Scientist. RAP is an Australian publicly listed company commercializing the technology under license from the University of Queensland, where U.A. is employed. U.A. is a named inventor of the UQ technology. V.S. and J.W. are employees of ResApp Health. N.B., J.B., C.S. and P.D. declare no competing interests.

Figures

Fig. 1
Fig. 1. The flow of participants through the study.
Depicts the recruitment and retention flow of participants in this study, leading to the final test cohort, including number with and without AECOPD.
Fig. 2
Fig. 2. Receiver operator curve.
Acute exacerbation of COPD (All ages): AUC = 0.89 (95% CI: 0.84–0.94).
Fig. 3
Fig. 3. Receiver operator curve.
Acute exacerbation of COPD (≥65 years): AUC = 0.91 (95% CI: 0.85–0.96).
See this image and copyright information in PMC

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