Cough says a lot about your health, if your smartphone is listening

Researchers around the world are trying to turn the humble cough into an inexpensive tool to diagnose and prevent respiratory-disease killers such as tuberculosis and COVID-19. They are collecting recordings of millions of explosive sounds from patients and consumers on smartphones and other devices. And they are training artificial intelligence to find patterns to identify the type and severity of illness from the cough itself.

“We call it acoustic epidemiology,” says Peter Small, a tuberculosis specialist and chief medical officer of Hyph Inc., a Delaware-based company that has two free smartphone apps—one for consumers, the other for researchers—that use AI. use to trace and track. How often does someone cough?

The sound and frequency of coughing are packed with medical information, he says. There are some audible differences in different diseases: cracking in parts of the lung for pneumonia, wheezing for asthma. The makers of these apps say there are sounds and patterns that AI can detect, but the human ear cannot hear.

Coughing is one of the most common symptoms of potential illness, the body’s attempt to protect itself from irritants or unwanted substances in the airways. Cough is one of the top reasons people go to the doctor.

Yet doctors often may not learn much about a patient’s cough during an office visit or a trip to the hospital, Dr. Smalls says. “Patients will come and say, ‘I have a bad cough,’ but are they coughing 10 times a day or 400 times a day?” they say. “Pulmonologists will tell you they’re like cardiologists without the blood pressure cuff.”

It’s difficult for patients to remember how much they are coughing, especially at night, says Kaiser Lim, MD, a pulmonologist at the Mayo Clinic in Rochester, Minn. Monitors will help doctors determine the amount of their cough, leaving more time in one visit to address the problem and the psychological impact, he says.

Covid-19, which has so far claimed over 4.5 million lives globally, has only added to the long-standing challenges. Cough-related diseases, including lung cancer, tuberculosis, chronic obstructive pulmonary disease and pneumonia, account for one-quarter of all deaths worldwide annually. Millions of people suffer from chronic cough and asthma-like respiratory problems—including Dr. Smalls, who has had an unexplained chronic cough for a decade. Other common causes include allergies and acid reflux.

Quiz: Guess the Cough

Can you identify which of the following cough is from someone with COVID-19? Bonus points if you can name illnesses for other coughs as well. See answer at the end of this article.

SOURCE: Dr. Paul Porter/Curtin University and RaceApp Health Ltd.

It will take some time for these tests to be widely implemented; Their creators are still creating the data sets and training the AI ​​to recognize coughs. For smartphones to listen, they also have to address concerns about privacy and data usage costs.

“One in two people who die of TB in South Africa have never visited a health facility for TB,” says Professor Grant Theron from Stellenbosch University in Cape Town. Tuberculosis. “It’s very important to capture those in the community from an epidemiological perspective.”

With an audio-based test, “you can screen hundreds of thousands of people at a very low cost per patient,” he says. People who test positive on the app will be given a lab test to see if they have TB, according to Thomas Nissler, a professor of electrical and electronic engineering at Stellenbosch. distinguish, although they are difficult or sometimes impossible to the human ear. Project.

The devices don’t need to be fully diagnosable, says Aditya Kattamanchi, a professor of medicine and epidemiology at the University of California San Francisco, who has been using the Hyph app to collect coughs in several countries for a large database of TB coughs. Huh. They can act more like a mammogram, alerting a doctor to a possible case and the need for more tests, he says.

Brisbane, Tony Keating says that ResApp Health Ltd. is using the explosion in telehealth services, especially during pandemics, to expand the use of app-based testing for cough sounds that helps doctors diagnose diseases including COPD, pneumonia, asthma and bronchitis helps. Chief Executive Officer of an Australia-based company. A telehealth provider asks a patient to hold a smartphone at arm’s length and record five coughs. The app analyzes the cough, then sends the results to the doctor.

Using technology developed by researchers at the University of Queensland, the company built the diagnostic tool by training an algorithm on 6,000 cough recordings, along with clinical data from those patients in the US and Australia, Mr Keating says. Huh.

The company is also collecting whooping cough from Covid-19 patients whose illness is confirmed with a gold-standard PCR test and developing a screening test for the disease in the US and India, among others. The goal is to diagnose the disease and try to predict whether the patient will develop a severe form, Mr. Keating says.

They say that X-rays reveal abnormal patterns in the lungs of Kovid-19 patients, which suggests that the disease produces a unique coughing sound. “It is not clear today whether there are patterns in the sound of a Covid-19 cough like asthma or pneumonia are patterns in the sound of a cough,” he says.

Still, he says he is confident they will find the pattern. Research at the Massachusetts Institute of Technology, the University of California San Diego and elsewhere suggests that a COVID-19 cough has detectable characteristics.

According to Dr. Small of Hyph, cough monitoring apps can alert patients and providers to an illness, as people often start coughing before they feel sick, or tell them that an illness is improving. is happening or getting worse. The apps could also monitor an office or nursing home, potentially detecting an outbreak or increase in respiratory illness if too many people are coughing, he says.

Hyph’s two apps run continuously on the smartphone and when the AI ​​hears an explosive sound, it records in a half-second clip. The AI ​​is not recording or interpreting any other sound, says Dr. Small. The apps recorded about 64 million sounds, of which about two million were identified by an algorithm as coughing. To teach the AI ​​how to better recognize coughs, the company had humans — including an unemployed bartender in rural Spain — listen to a million voices.

Researchers are using more than a dozen studies around the world, including one to build a database of TB coughs and another to monitor cough patterns in a community in Navarra, Spain.

An ongoing study in Spain has shown that people may start coughing more often without realizing it, potentially indicating they have an illness. A 35-year-old woman’s hourly cough tripled the night before she developed other COVID-19 symptoms and was diagnosed with the disease. It was only two days after that he thought he had a cough, the researchers found.

Hife CEO Joe Bru hired his company’s app when his 3-year-old son, Galileo, was hospitalized with pneumonia in June. When the doctors made their rounds, “they always said, ‘How’s his cough? Mr Bru remembers. He showed them his data from the app, which showed that Galileo’s cough had dropped from less than 300 per hour to 30 per hour over a few days, he says. “They loved it,” he says.

Quiz Answer: 1. A 5 year old suffering from Asthma. 2. A 34-year-old suffering from asthma. 3. A 55-year-old chronic obstructive pulmonary disease. 4. A 45-year-old man with COVID-19. 5. A 37-year-old man with pneumonia.