Analysis of wheeze sounds during tidal breathing according to severity levels in asthma patients

Abstract

Objective: This study aimed to statistically analyze the behavior of time-frequency features in digital recordings of wheeze sounds obtained from patients with various levels of asthma severity (mild, moderate, and severe), and this analysis was based on the auscultation location and/or breath phase. Method: Segmented and validated wheeze sounds were collected from the trachea and lower lung base (LLB) of 55 asthmatic patients during tidal breathing maneuvers and grouped into nine different datasets. The quartile frequencies F₂₅, F₅₀, F₇₅, F₉₀ and F₉₉, mean frequency (MF) and average power (AP) were computed as features, and a univariate statistical analysis was then performed to analyze the behavior of the time-frequency features. Results: All features generally showed statistical significance in most of the datasets for all severity levels [χ² = 6.021–71.65, p < 0.05, η² = 0.01–0.52]. Of the seven investigated features, only AP showed statistical significance in all the datasets. F₂₅, F₇₅, F₉₀ and F₉₉ exhibited statistical significance in at least six datasets [χ² = 4.852–65.63, p < 0.05, η² = 0.01–0.52], and F₂₅, F₅₀ and MF showed statistical significance with a large η² in all trachea-related datasets [χ² = 13.54–55.32, p < 0.05, η² = 0.13–0.33]. Conclusion: The results obtained for the time-frequency features revealed that (1) the asthma severity levels of patients can be identified through a set of selected features with tidal breathing, (2) tracheal wheeze sounds are more sensitive and specific predictors of severity levels and (3) inspiratory and expiratory wheeze sounds are almost equally informative.

Keywords:

• Asthma
• breath sounds
• wheeze detection
• airway obstruction
• severity level

Acknowledgements

We thank Universiti Teknikal Malaysia Melaka and the FRGS scheme (FRGS/1/2016/TK04/UTEM/01/1) for providing a conducive research platform for this work. We would like to thank the physicians and hospitals that participated in this study, the Director General of Health Malaysia for giving us permission to publish this paper and the Medical Research and Ethics Committee (MREC) of Malaysia for providing ethical approval to collect the data used in this study (NMRR-13–1684-16483).

Disclosure statement

The authors declare that they have no conflict of interest. This study was not supported by any sources of funding.