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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.

Transmission Perspective on the Mechanism of Coarse and Fine Crackle Sounds

Lu Bing-Yuh, Hsueh Meng-Lun, Wu Huey-Dong

Archives of Acoustics

2021

Vol. 46, No. 2

289--300

The possibility of a normal distribution indicates that few particles are in the same phase during a breath and their reflections can be observed on the chest wall, then a few explosive waves with relatively large power occurr occasionally. Therefore, the one-cycle sine wave which is simulated as a single burst of the explosive effect phenomenon penetrates through the chest wall and was analysed to explore the reason of the crackle sounds. The results explain the differences between the definitions of crackle proposed by Sovijärvi et al. (2000a). The crackles in the lungs were synthesised by a computer simulation. When the coarse crackles occur, the results indicate that higher burst frequency carriers (greater than 100 Hz) directly penetrate the bandpass filter to simulate the chest wall. The simulated coarse crackle sounds were low pitched, with a high amplitude and long duration. The total duration was greater than 10 ms. However, for a lower frequency carrier (approximately 50 Hz), the fundamental frequency component was filtered out. Therefore, the second harmonic component of the lower frequency carrier, i.e., the fine crackle, penetrated the chest wall. Consequently, it is very possible that the normal lung sounds may contain many crackle-shaped waves with very small amplitudes because of the filtering effects of the chest wall, environment noises, electric devices, stethoscopes, and human ears, the small crackles disappear in the auscultations. In addition, our study pointed out that some unknown crackles of the very low frequency under the bandwidth of the human ears cannot penetrate the airways and be detected by medical doctors. Therefore, it might be necessary to focus advanced electronic instrumentation on them in order to analyse their possible characteristics for diagnosis and treatment of the respiration system.