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Advancing Auscultation Education: Signals Visualization as a Novel Tool for Enhancing Pathological Respiratory Sounds Detection

Pastusiak Anna Katarzyna, Hafke-Dys Honorata, Kociński Jędrzej, Szarzyński Krzysztof, Janeczek Kamil

Polish Journal of Medical Physics and Engineering

2024

Vol. 30, Iss.1

1--10

Introduction: Auscultation remains a pivotal diagnostic modality for various respiratory pathologies. To augment its clinical relevance, the continuous expansion of our understanding of pulmonary acoustics, coupled with the advancement of auscultation recording and analysis methodologies, is imperative. Material and methods: We investigated how the bimodal presentation of auscultatory signals (sound and visual cue perception) influences the subjective efficacy of pathological respiratory sound detection, which is a critical step in the development of a new auscultation tool. Recordings of pediatric breath sounds were presented in three different forms - audio only, visual representation only (spectrogram) or audiovisual (both together). The F1-score, sensitivity and specificity parameters were calculated and compared to the gold standard (GS). Subsequent to the detection experiment, participants completed a survey to subjectively assess the usability of spectrograms in the procedure. Results: Over 60% of all responders ranked the spectrogram as important (40.8%) or very important (21.1%). Moreover, 11.3% of all participants found this new form of presentation of auscultation results to be more useful than the evaluation of sound only. The addition of visual information did not statistically significantly change the evaluation of the sounds themselves, an observable trend implies that enhancing audio recordings with visualizations can enhance detection performance. This is evident in the 4 p.p. and 2 p.p. sensitivity increments for physicians and students, respectively, even without specialized visual training. Conclusions: Our research findings indicate that the integration of spectrograms with conventional auditory assessment, albeit based on observed trends and survey responses, presents a promising avenue for improving the precision and quality of medical education, as well as enhancing diagnosis and monitoring processes.

The Benefit of Binaural Hearing Among Listeners with Sensorineural Hearing Loss

Pastusiak Anna, Niemiec Dawid, Kociński Jędrzej, Warzybok Anna

Archives of Acoustics

2019

Vol. 44, No. 4

709--717

The performance of binaural processing may be disturbed in the presence of hearing loss, especially of sensorineural type. To assess the impact of hearing loss on speech perception in noise regarding binaural processing, series of speech recognition measurements in controlled laboratory conditions were carried out. The spatial conditions were simulated using dummy head recordings played back on headphones. The Intelligibility Level Difference (ILD) was determined by measuring the change in the speech reception thresholds (SRT) between two configurations of a masking signal source (N) and a speech source (S), namely the S0N90 condition (where numbers stand for angles in horizontal plane) and the co-located condition (S0N0). To disentangle the head shadow effect (better ear effect) from binaural processing in the brain, the difference between binaural and monaural S0N90 condition (so-called Binaural Intelligibility Level Difference, BILD) value was calculated. Measurements were performed with a control group of normal-hearing listeners and a group of sensorineural hearing-impaired subjects. In all conditions performance of the hearing-impaired listeners was significantly lower than normal-hearing ones, resulting in higher SRT values (3 dB difference in the S0N0 configuration, 7.6 dB in S0N90 and 5 dB in monaural S0N90). The SRT improvement due to the spatial separation of target and masking signal (ILD) was also higher in the control group (8.1 dB) than in hearing-impaired listeners (3.5 dB). Moreover, a significant deterioration of the binaural processing described by BILD was found in people with sensorineural deficits. This parameter for normal-hearing listeners reached a value of 3 to 6 dB (4.6 dB on average) and decreased more than two times in the hearing-impaired group to 1.9 dB on average (with a deviation of 1.4 dB). These findings could not be explained by individual average hearing threshold (standard in audiological diagnostics) only. The outcomes indicate that there is a contribution of suprathershold deficits and it may be useful to consider binaural SRT measurements in noise in addition to the pure tone audiometry resulting in better diagnostics and hearing aid fitting.