Telehealth has shown potential to improve access to health-care cost-effectively in respiratory illness. However, it has failed to live up to expectation, in part because of poor objective measures of symptoms such as cough events, which could lead to early diagnosis or prevention. Considering the burden that these conditions constitute for national health systems, an effort is needed to foster telehealth potential by developing low cost technology for efficient monitoring and analysis of cough events. This paper, proposes the use of local Hu moments as a robust feature set for automatic cough detection in smartphone-acquired audio signals. The final system feeds a k-Nearest Neighbors classifier with the extracted features. To properly evaluate the system in a diversity of noisy backgrounds, we contaminated real cough audio data with a variety of sounds including noise from both indoor and outdoor environments, and non-cough events (sneeze, laugh, speech, etc.). The created database allows flexible settings of Signal to Noise Ratio (SNR) levels between background sounds and events (cough and non-cough). This evaluation was complemented using real patient data from an outpatient clinic. The system is able to detect cough events with high sensitivity (up to 88.51%) and specificity (up to 99.77%) in a variety of noisy environments, overcoming other state-of-the-art audio features. Our proposal paves the way for ubiquitous cough monitoring with minimal disruption in daily activities.

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The potential  of telemedicine in respiratory health care has not been completely unveiled in part due to the inexistence of reliable objective measurements of symptoms such as cough. Currently available cough detectors are uncomfortable and expensive at a time when generic smartphones can perform this task. However, two major challenges preclude smartphone-based cough detectors from effective deployment namely, the need to deal with noisy environments and computational cost. This paper focuses on the latter, since complex machine learning algorithms are too slow for real-time use and kill the battery in a few hours unless specific actions are taken. In this paper, we present a robust and efficient implementation of a smartphone-based cough detector. The audio signal acquired from the device's microphone is processed by computing local Hu moments as a robust feature set in the presence of background noise. We previously demonstrated that pairing Hu moments and a standard k-NN classifier achieved accurate cough detection at the expense of computation time. To speed-up k-NN search, many tree structures have been proposed. Our cough detector uses an improved vantage point (vp)-tree with optimized construction methods and a distance function that results in faster searches. We achieve 18× speed-up over classic vp-trees, and 560× over standard implementations of k-NN in state-of-the-art machine learning libraries, with classification accuracies over 93%, enabling real-time performance on low-end smartphones.

This paper proposes a new cough detection system based on audio signals acquired from conventional smartphones. The system relies on local Hu moments to characterize cough events and a Λ-NN classifier to distinguish cough events from non-cough ones (speech, laugh, sneeze, etc.) and noisy sounds. To deal with the unbalance between classes, we employ Distinct-Borderline2 Synthetic Minority Oversampling Technique and a bespoke cost matrix. The system additionally features a post-processing module to avoid isolated false negatives and, this way, increases sensitivity. Evaluation has been carried out using a database comprising a variety of cough and non-cough events and different types of background noise. In this study, we specifically focused on noise likely to appear when the user is carrying the smartphone in daily activities. Different Signal to Noise Ratio values were tested ranging between -15 and 0 dB. Our experiments confirm that local Hu moments are suitable not only for characterizing cough events but also for coping with noisy environments. Results show a sensitivity of 94.17% and a specificity of 92.16% at -15 dB. Thus, our system shows potential as a reliable and place-ubiquitous monitoring device that helps patients self-manage their own respiratory diseases and avoids unreported or fabricated symptoms.