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Validation of a small cough detector

Manuel Kuhn, Elif Nalbant, Dario Kohlbrenner, Mitja Alge, Laura Kuett, Alexandra Arvaji, Noriane A. Sievi, Erich W. Russi, Christian F. Clarenbach
ERJ Open Research 2023 9: 00279-2022; DOI: 10.1183/23120541.00279-2022
Manuel Kuhn
1Faculty of Medicine, University of Zurich, Zurich, Switzerland
2Department of Pulmonology, University Hospital Zurich, Zurich, Switzerland
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  • For correspondence: manuel.kuhn@usz.ch
Elif Nalbant
3SIVA Health AG, Zurich, Switzerland
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Dario Kohlbrenner
2Department of Pulmonology, University Hospital Zurich, Zurich, Switzerland
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  • ORCID record for Dario Kohlbrenner
Mitja Alge
3SIVA Health AG, Zurich, Switzerland
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Laura Kuett
3SIVA Health AG, Zurich, Switzerland
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Alexandra Arvaji
2Department of Pulmonology, University Hospital Zurich, Zurich, Switzerland
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Noriane A. Sievi
2Department of Pulmonology, University Hospital Zurich, Zurich, Switzerland
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Erich W. Russi
1Faculty of Medicine, University of Zurich, Zurich, Switzerland
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Christian F. Clarenbach
1Faculty of Medicine, University of Zurich, Zurich, Switzerland
2Department of Pulmonology, University Hospital Zurich, Zurich, Switzerland
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  • ORCID record for Christian F. Clarenbach
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Figures

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  • FIGURE 1
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    FIGURE 1

    The SIVA-P3 cough detector worn on the patient's chest. a, b) The cough detector. Note that in this pilot study, it was intended to be worn between layers of clothing, but for illustration purposes, it is worn over the clothes in this figure; c) smartphone application; d) cloud storage, where the data are saved and processed; e) data are presented on a dashboard in a user-friendly way.

  • FIGURE 2
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    FIGURE 2

    Relationship between cough epochs and cough explosions for a) daytime and b) night-time. Each point depicts the data of one patient during the first day (n=27).

  • FIGURE 3
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    FIGURE 3

    Box plots depicting the a) average cough explosions per hour for the full week and b) average cough epochs per hour for the full week.

  • FIGURE 4
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    FIGURE 4

    a) Receiver operating characteristic curve for day and night, including the area under the curve (AUC); b) curve plotting positive predictive value against sensitivity for day and night, including the AUC.

  • FIGURE 5
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    FIGURE 5

    Correlation plot of daily average cough epochs per hour between the SIVA-P3 algorithm and a human listener for a) daytime use and b) night-time use. Each point depicts the data of a single patient over the first 24 h. The Spearman's correlation coefficient for daytime use is 0.95 (95% CI 0.90–0.98) and for night-time use is 0.94 (95% CI 0.88–0.97).

  • FIGURE 6
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    FIGURE 6

    Bland–Altman plot of the daily average cough epochs per hour showing the difference between a human listener and the SIVA-P3 algorithm for a) daytime use and b) night-time use. Data are presented as the data points of single patients over the first 24 h, means (dashed red lines) and 95th percentiles (black dashed lines).

  • FIGURE 7
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    FIGURE 7

    Likert scale responses to the statement “I found wearing the cough detector comfortable”. n=25.

Tables

  • Figures
  • Supplementary Materials
  • TABLE 1

    Study participant demographics

    Patients27
    Age, years50.3±13.9
    53 (25–79)
    Male/female15/12
    BMI, kg·m−224.4±0.8
    Cough severity VAS, mm41.6±23.4
    Average cough epochs in first 24 h88.5±79
    Underlying condition
     Chronic cough of unknown origin12 (45)
     COPD4 (15)
     Asthma5 (18)
     Interstitial lung disease6 (22)

    Data are presented as n, mean±sd, median (range) or n (%). BMI: body mass index; VAS: visual analogue scale.

    • TABLE 2

      Mean values (95% CI) for daytime and night-time usage

      DaytimeNight-time
      Sensitivity (recall), %88.55 (85.86–90.85)84.24 (79.11–89.06)
      Specificity, %99.97 (99.96–99.98)*99.97 (99.95–99.99)*
      Positive predictive value, %89.68 (87.64–91.57)87.06 (82.91–90.64)
      Negative predictive value, %99.97 (99.96–99.97)*99.97 (99.94–99.98)*
      False positives per hour0.39 (0.49–0.31)0.24 (0.33–0.15)
      False negatives per hour0.44 (0.57–0.33)0.3 (0.42–0.19)

      *: p<0.05 between day and night.

      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 00279-2022_figure_S1

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      Validation of a small cough detector
      Manuel Kuhn, Elif Nalbant, Dario Kohlbrenner, Mitja Alge, Laura Kuett, Alexandra Arvaji, Noriane A. Sievi, Erich W. Russi, Christian F. Clarenbach
      ERJ Open Research Jan 2023, 9 (1) 00279-2022; DOI: 10.1183/23120541.00279-2022

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      Validation of a small cough detector
      Manuel Kuhn, Elif Nalbant, Dario Kohlbrenner, Mitja Alge, Laura Kuett, Alexandra Arvaji, Noriane A. Sievi, Erich W. Russi, Christian F. Clarenbach
      ERJ Open Research Jan 2023, 9 (1) 00279-2022; DOI: 10.1183/23120541.00279-2022
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