Cough Audio Recognition for Early Detection of Respiratory Diseases: Algorithm Development and Validation Study

Clinical Snapshot

Key Findings

• P Value: Not reported

• Effect Size: 83.9% accuracy with CAM-ResNet18 vs 78.16% with traditional ResNet18

• Primary Outcome: Classification accuracy for 5 types of cough sounds

• Nnt Or Sensitivity: Sensitivity and specificity not reported - only overall accuracy and F1-score (82.52%)

• Confidence Interval: Not reported

Clinical Application

Requires smartphone or recording device and internet connectivity for algorithm processing - technically feasible but needs clinical validation Could complement telehealth initiatives and rural healthcare delivery, but would require TGA approval as medical device software and integration with existing clinical pathways Patients with suspected respiratory diseases presenting with cough, particularly in resource-limited settings

Abstract

BACKGROUND: Coughing is a common clinical symptom and a protective respiratory reflex closely associated with various respiratory system diseases. The acoustic characteristics of cough sounds are influenced by underlying pathological factors, with distinct acoustic signatures corresponding to different etiologies. Through rigorous analysis of these sounds, rapid identification and preliminary diagnosis of related conditions may be achieved. This approach holds great potential for broad application in mobile health and ubiquitous health platforms. OBJECTIVE: This study aimed to explore the application of acoustic analysis of cough sounds in the diagnosis of respiratory diseases to enhance the diagnostic efficiency of health care professionals. METHODS: In this study, we conducted extensive data collection, including voluntary cough audio recordings from patients diagnosed with respiratory diseases (eg, chronic obstructive pulmonary disease, lung cancer, COVID-19, and pneumonia) and from healthy participants. A total of 2610 audio samples were collected. We incorporated a channel attention mechanism (CAM) into the final convolutional block of each residual block in the ResNet18 neural network, thereby constructing the CAM-ResNet18 neural network model. The recorded cough audio samples were converted into spectrograms to form the input dataset for model training. The CAM-ResNet18 model was trained on the training set of this dataset, with iterative parameter adjustments until convergence was achieved. Finally, spectrograms from the test set were fed into the pretrained model for accurate classification of the cough-related conditions. RESULTS: Experimental results on the collected audio dataset demonstrate that the proposed CAM-ResNet18 model achieves an accuracy of 83.9% and an average F1-score of 82.52% in classifying 5 types of cough sounds. In comparison, the traditional ResNet18 model achieves an accuracy of 78.16% and an average F1-score of 78.29%, indicating a clear performance improvement with the integration of the CAM. CONCLUSIONS: The experimental results validate the effectiveness of the proposed method, highlighting its significant potential for application in clinical diagnosis.

References

1. 1.Sun, W., Zou, J., Yin, N., Fang, W., Sun, J., Miao, Z., & Yang, S. (2026). Cough audio recognition for early detection of respiratory diseases: Algorithm development and validation study. JMIR Medical Informatics. https://doi.org/10.1109/JBHI.2019.2931395