Practical implementation of artificial intelligence algorithms in pulmonary auscultation examination

Abstract

Lung auscultation is an important part of a physical examination. However, its biggest drawback is its subjectivity. The results depend on the experience and ability of the doctor to perceive and distinguish pathologies in sounds heard via a stethoscope. This paper investigates a new method of automatic sound analysis based on neural networks (NNs), which has been implemented in a system that uses an electronic stethoscope for capturing respiratory sounds. It allows the detection of auscultatory sounds in four classes: wheezes, rhonchi, and fine and coarse crackles. In the blind test, a group of 522 auscultatory sounds from 50 pediatric patients were presented, and the results provided by a group of doctors and an artificial intelligence (AI) algorithm developed by the authors were compared. The gathered data show that machine learning (ML)–based analysis is more efficient in detecting all four types of phenomena, which is reflected in high values of recall (also called as sensitivity) and F1-score.

Conclusions: The obtained results suggest that the implementation of automatic sound analysis based on NNs can significantly improve the efficiency of this form of examination, leading to a minimization of the number of errors made in the interpretation of auscultation sounds.

What is Known: • Auscultation performance of average physician is very low. AI solutions presented in scientific literature are based on small data bases with isolated pathological sounds (which are far from real recordings) and mainly on leave-one-out validation method thus they are not reliable.

What is New: • AI learning process was based on thousands of signals from real patients and a reliable description of recordings was based on multiple validation by physicians and acoustician resulting in practical and statistical prove of AI high performance.