PT - JOURNAL ARTICLE AU - William Do AU - Richard Russell AU - Christopher Wheeler AU - Hamza Javed AU - Cihan Dogan AU - George Cunningham AU - Vikaran Khanna AU - Maarten De Vos AU - Imran Satia AU - Mona Bafadhel AU - Ian Pavord TI - Performance of cough monitoring by Albus Home™, a contactless and automated system for nocturnal respiratory monitoring at home AID - 10.1183/23120541.00265-2022 DP - 2022 Jan 01 TA - ERJ Open Research PG - 00265-2022 4099 - http://openres.ersjournals.com/content/early/2022/08/11/23120541.00265-2022.short 4100 - http://openres.ersjournals.com/content/early/2022/08/11/23120541.00265-2022.full AB - 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.FootnotesThis 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 HealthConflicts 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 workConflicts of Interest: CW, HJ, CD, GC, VK were employees of Albus Health during the conduct of the studyConflicts 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 workConflicts 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 workConflicts 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 workConflicts 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.