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Performance of cough monitoring by Albus Home™, a contactless and automated system for nocturnal respiratory monitoring at home

William Do, Richard Russell, Christopher Wheeler, Hamza Javed, Cihan Dogan, George Cunningham, Vikaran Khanna, Maarten De Vos, Imran Satia, Mona Bafadhel, Ian Pavord
ERJ Open Research 2022; DOI: 10.1183/23120541.00265-2022
William Do
1Albus Health, Oxford, United Kingdom
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  • For correspondence: william.do@albushealth.com
Richard Russell
2Respiratory Medicine Unit, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom
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Christopher Wheeler
3Royal Brompton Hospital, London, United Kingdom
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Hamza Javed
1Albus Health, Oxford, United Kingdom
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Cihan Dogan
1Albus Health, Oxford, United Kingdom
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George Cunningham
1Albus Health, Oxford, United Kingdom
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Vikaran Khanna
1Albus Health, Oxford, United Kingdom
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Maarten De Vos
4Department of Electrical Engineering and Department of Development and Regeneration, KU Leuven, Leuven, Belgium
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Imran Satia
5Department of Medicine, Division of Respirology, McMaster University, Hamilton, Canada
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Mona Bafadhel
6Faculty of Life Sciences and Medicine, School of Immunology and Microbial Sciences, King's College London, London, United Kingdom
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Ian Pavord
2Respiratory Medicine Unit, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom
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Abstract

Introduction Objective cough frequency is a key clinical endpoint but existing wearable monitors are limited to 24-h recordings. Albus Home uses contactless motion, acoustic and environmental sensors to monitor multiple metrics, including respiratory rate and cough without encroaching on patient lifestyle. The aim of this study was to evaluate measurement characteristics of nocturnal cough monitoring by Albus Home compared to manual counts.

Methods Adults with respiratory conditions underwent overnight monitoring using Albus Home in their usual bedroom environments. Participants set-up the plug-and-play device themselves. For reference counts, each audio recording was counted by two annotators, and cough defined as explosive phases audio-visually labelled by both. In parallel, recordings were processed by a proprietary Albus system, comprising a deep-learning algorithm with a human screening step for verifying or excluding occasional events that mimic cough. Performance of the Albus system in detecting individual cough events and reporting hourly cough counts was compared against reference counts.

Results 30 nights from 10 subjects comprised 375 h(h) of recording. Mean (s.d.) coughs/night were 90 (76). Coughs·h−1 ranged from 0 to 129. Albus counts were accurate across hours with high and low cough frequencies, with median sensitivity, specificity, positive-predictive-value, negative-predictive-values of 94.8,100.0,99.1, and 100.0% respectively. Agreement between Albus and reference was strong (Intra-class Correlation Coefficient[ICC] 0.99; 95%CI 0.99-0.99; p<0.001) and equivalent to agreement between observers and reference counts (ICC 0.98, 0.99 respectively).

Conclusions Albus Home provides a unique, contactless and accurate system for cough monitoring, enabling collection of high-quality and potentially clinically relevant longitudinal data.

Footnotes

This manuscript has recently been accepted for publication in the ERJ Open Research. It is published here in its accepted form prior to copyediting and typesetting by our production team. After these production processes are complete and the authors have approved the resulting proofs, the article will move to the latest issue of the ERJOR online. Please open or download the PDF to view this article.

Conflicts of Interest: WD is a co-founding shareholder and director of Albus Health

Conflicts of Interest: RR is a scientific advisor and minority shareholder of Albus Health; and reports grants from AstraZeneca, and personal fees from Boehringer Ingelheim, Chiesi UK, and GlaxoSmithKline, outside of the submitted work

Conflicts of Interest: CW, HJ, CD, GC, VK were employees of Albus Health during the conduct of the study

Conflicts of Interest: MDV reports consulting fees and minority shareholding from Albus Health; and reports grants from J&J/Janssen and public government outside of submitted work

Conflicts of Interest: IS reports grants from Merck, GSK, Bellus and Bayer, personal speaker and consulting fees from GSK, AstraZeneca, Merck, Genentech, and Respiplus outside the submitted work

Conflicts of Interest: MB is a scientific advisor and minority shareholder of Albus Health; and reports grants from AstraZeneca, personal fees from AstraZeneca, Chiesi, and GlaxoSmithKline, and is a scientific advisor of ProAxsis, outside of the submitted work

Conflicts of Interest: IP has received speaker's honoraria for speaking at sponsored meetings from AstraZeneca, Boehringer Ingelheim, Aerocrine AB, Almirall, Novartis, Teva, Chiesi, Sanofi/Regeneron, Menarini, and GSK, and payments for organising educational events from AstraZeneca, GSK, Sanofi/Regeneron, and Teva. He has received honoraria for attending advisory panels with Genentech, Sanofi/Regeneron, AstraZeneca, Boehringer Ingelheim, GSK, Novartis, Teva, Merck, Circassia, Chiesi, and Knopp, and payments to support FDA approval meetings from GSK. He has received sponsorship to attend international scientific meetings from Boehringer Ingelheim, GSK, AstraZeneca, Teva, and Chiesi. He has received grants from Chiesi and Sanofi Genzyme. He is co-patent holder of the rights to the Leicester Cough Questionnaire and has received payments for its use in clinical trials from Merck, Bayer, and Insmed, outside of the submitted work.

  • Received June 1, 2022.
  • Accepted August 8, 2022.
  • Copyright ©The authors 2022
http://creativecommons.org/licenses/by-nc/4.0/

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Performance of cough monitoring by Albus Home™, a contactless and automated system for nocturnal respiratory monitoring at home
William Do, Richard Russell, Christopher Wheeler, Hamza Javed, Cihan Dogan, George Cunningham, Vikaran Khanna, Maarten De Vos, Imran Satia, Mona Bafadhel, Ian Pavord
ERJ Open Research Jan 2022, 00265-2022; DOI: 10.1183/23120541.00265-2022

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Performance of cough monitoring by Albus Home™, a contactless and automated system for nocturnal respiratory monitoring at home
William Do, Richard Russell, Christopher Wheeler, Hamza Javed, Cihan Dogan, George Cunningham, Vikaran Khanna, Maarten De Vos, Imran Satia, Mona Bafadhel, Ian Pavord
ERJ Open Research Jan 2022, 00265-2022; DOI: 10.1183/23120541.00265-2022
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