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Acoustic surveillance of cough for detecting respiratory disease using artificial intelligence

Juan C. Gabaldón-Figueira, Eric Keen, Gerard Giménez, Virginia Orrillo, Isabel Blavia, Dominique Hélène Doré, Nuria Armendáriz, Juliane Chaccour, Alejandro Fernandez-Montero, Javier Bartolomé, Nita Umashankar, Peter Small, Simon Grandjean Lapierre, Carlos Chaccour
ERJ Open Research 2022 8: 00053-2022; DOI: 10.1183/23120541.00053-2022
Juan C. Gabaldón-Figueira
1Dept of Microbiology and Infectious Diseases, Clinica Universidad de Navarra, Pamplona, Spain
2ISGlobal, Hospital Clinic, University of Barcelona, Barcelona, Spain
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  • ORCID record for Juan C. Gabaldón-Figueira
  • For correspondence: juancarlos.gabaldon@isglobal.org
Eric Keen
3Research and Development Dept, Hyfe Inc, Wilmington, DE, USA
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Gerard Giménez
3Research and Development Dept, Hyfe Inc, Wilmington, DE, USA
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Virginia Orrillo
4School of Pharmacy and Nutrition, University of Navarra, Pamplona, Spain
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Isabel Blavia
4School of Pharmacy and Nutrition, University of Navarra, Pamplona, Spain
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Dominique Hélène Doré
5Immunopathology Axis, Research Center of the University of Montreal Hospital Center, Montréal, QC, Canada
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Nuria Armendáriz
6Primary Healthcare, Navarra Health Service-Osasunbidea, Zizur Mayor, Spain
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Juliane Chaccour
1Dept of Microbiology and Infectious Diseases, Clinica Universidad de Navarra, Pamplona, Spain
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  • ORCID record for Juliane Chaccour
Alejandro Fernandez-Montero
7Dept of Occupational Medicine – COVID-19 Area, Clinica Universidad de Navarra, Pamplona, Spain
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Javier Bartolomé
6Primary Healthcare, Navarra Health Service-Osasunbidea, Zizur Mayor, Spain
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Nita Umashankar
8Fowler College of Business, San Diego State University, San Diego, CA, USA
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Peter Small
3Research and Development Dept, Hyfe Inc, Wilmington, DE, USA
9Dept of Global Health, University of Washington, Seattle, WA, USA
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Simon Grandjean Lapierre
5Immunopathology Axis, Research Center of the University of Montreal Hospital Center, Montréal, QC, Canada
10Dept of Microbiology, Infectious Diseases and Immunology, Research Center of the University of Montreal Hospital Center, Montreal, QC, Canada
12These authors contributed equally
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Carlos Chaccour
1Dept of Microbiology and Infectious Diseases, Clinica Universidad de Navarra, Pamplona, Spain
2ISGlobal, Hospital Clinic, University of Barcelona, Barcelona, Spain
11Centro de Investigación Biomédica en Red de Enfermedades Infecciosas, Madrid, Spain
12These authors contributed equally
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  • FIGURE 1
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    FIGURE 1

    Flow chart of participants analysed in the study. Approximately 35 000 people were estimated to have been reached via social network information campaigns. Of these, 930 were enrolled in the study. Only 616 participants recorded data for ⩾1 h, and were therefore included in the autoregressive moving average (ARIMA) and usage analyses. Similarly, only 272 participants consulted medical services during the study period. Of these, only 33 recorded ⩾24 h of data both in and outside the consultation period, and were included in the analysis of cough frequency changes as a function of consultation dates.

  • FIGURE 2
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    FIGURE 2

    Difference between cough rates in the consultation period compared to the participants’ monitoring history. Cough frequency during the consultation period is compared to the entire monitoring history (n=33), and the parsed pre- (n=23) and post-consultation history (n=29). Shaded areas represent the distribution of effect sizes predicted under a null model of no difference. The black line represents the actual observed difference between the consultation period and compared periods. Cough frequency during the consultation period significantly increased when compared to the entire history and the post-consultation history (p<0.00001 in both cases), but not when compared to the pre-consultation history (p=0.855).

  • FIGURE 3
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    FIGURE 3

    Cough and usage trends compared to coronavirus disease 2019 (COVID-19) incidence. Incidence of COVID-19 in a) the entire study area compared to b) the evolution of cough trends in the monitored cohort; c) after the exclusion of the participant with chronic cough; and d) compared to the number of active users. The continuous line represents the 7-day rolling average.

Tables

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  • TABLE 1

    Cohort characteristics and cough monitoring periods

    RecruitedMonitoring periods
    ≥1 h≥100 h≥240 h
    Age, years21 (20–24)21 (20–25)25 (21–50)50 (39–56)
    Operating system
     Android366 (39.4)269 (43.7)127 (71.3)18 (85.7)
     iOS559 (60.1)345 (56.0)51 (28.7)3 (14.3)
     Not specified5 (0.5)2 (0.3)00
    Participants93061617821

    Data are presented as median (interquartile range), n (%) or n.

    • TABLE 2

      Changes in cough rates during the consultation period and participant monitoring history

      ParticipantsObserved difference in cough rate (coughs·h−1)p-value
      Consultation period (days −5 to +4)#
       Full user history33+0.77±2.62<0.00001
       Pre-consultation history (before day −5)23−0.25±1.890.855
       Post-consultation history (after day +4)29+1.08±2.92<0.00001

      Data are presented as n or mean±sd, unless otherwise stated. #: day 0=date of consultation.

      Supplementary Materials

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      • Supplementary Material

        Please note: supplementary material is not edited by the Editorial Office, and is uploaded as it has been supplied by the author.

        Supplementary material 00053-2022.SUPPLEMENT

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      Acoustic surveillance of cough for detecting respiratory disease using artificial intelligence
      Juan C. Gabaldón-Figueira, Eric Keen, Gerard Giménez, Virginia Orrillo, Isabel Blavia, Dominique Hélène Doré, Nuria Armendáriz, Juliane Chaccour, Alejandro Fernandez-Montero, Javier Bartolomé, Nita Umashankar, Peter Small, Simon Grandjean Lapierre, Carlos Chaccour
      ERJ Open Research Apr 2022, 8 (2) 00053-2022; DOI: 10.1183/23120541.00053-2022

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      Acoustic surveillance of cough for detecting respiratory disease using artificial intelligence
      Juan C. Gabaldón-Figueira, Eric Keen, Gerard Giménez, Virginia Orrillo, Isabel Blavia, Dominique Hélène Doré, Nuria Armendáriz, Juliane Chaccour, Alejandro Fernandez-Montero, Javier Bartolomé, Nita Umashankar, Peter Small, Simon Grandjean Lapierre, Carlos Chaccour
      ERJ Open Research Apr 2022, 8 (2) 00053-2022; DOI: 10.1183/23120541.00053-2022
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