2009 Body Sensor Networks

Detection of Wheezes using A Wearable Distributed Array of Microphones

Wee Ser, T. T. Zhang, Jufeng Yu and Jianmin Zhang Center For Signal Processing Nanyang Technological University Singapore ewser@ntu.edu.sg, ttzhang@ntu.edu.sg, jfyu@ntu.edu.sg, zhangjm@ntu.edu.sg Wheezy sounds in signal analysis are represented as adventitious sounds which are overlapped to the normal respiratory sounds with a duration long enough to perceive a musical tone (80-250 ms) and with a frequency range from 100 to over 2000 Hz [6]. Wheezes are caused by narrowing, constriction, or spasm in the very small airways. They can occur because of asthma, congestive heart failure, brosis, pneumonia, and tuberculosis [3]. However, by means of E-auscultation, the detection of wheeze has largely been conned in the face of insufcient experiment data and unt classication methods. Many works on wheeze detection were based on methodologies and techniques that combined spectra analysis with criteria or rules concerning the amplitude, duration and pitch range of wheezes [5]- [9]. For instance, wheezes were detected in running spectra of lung sounds by use of a frequency domain peak detection algorithm in [5]. The frequencies and patterns of wheeze spectrograms were evaluated for gas density effects. It is shown that both wheeze frequency and patterns did not exhibit consistent changes with gas density. In [6], the investigation that the use of a Shabtai-Musih inspired algorithm is performed to detect wheezes on the time (ow)-frequency domain. It scans the signal with a constant moving window and calculates its spectral representation. The spectrum was controlled by subtracting its mean and normalizing by its standard deviation. Peak frequencies (FP) were selected as wheezing sounds if they comply with a set of fuzzy rules. This algorithm was proved effective to detect long and powerful wheezes which are mainly originated due to airway utter mechanisms. It can not work on other wheeze types. The frequency analysis of respiratory sounds during spontaneous ventilation was studied in [7]. In this work, the analysis of respiratory sounds in frequency domain and during spontaneous ventilation was lead to a simple classication method by evaluate peak frequency of expiration. Using an autoregressive model, it calculated the power spectral density (PSD) in each expiration phase and estimated the FP. High values of FP were found in wheezy patients with severe obstruction. The investigations by [8] and [9] are all based on the spectrogram of the breathing sounds recordings. In [8],
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AbstractThis paper presents a wheeze detection method that uses a distributed array of microphones and can be implemented as part of a wearable health monitoring system. In order to reduce the power consumption for the wearable system, the method has been developed to operate at a sampling rate of 1000Hz, instead of 8000Hz. In the design, we use two regular air conductive microphones and a bone conductive microphone to increase the accuracy of detection and make it robust against environmental noise. The two air-conductive microphones capture breathing sound while bone-conductive microphone is placed over the manubrium of the sternum in patients to record chest wall lung sound. The simulations are conducted using lung sounds from patients with wheezes and human subjects with no wheezes under different SNR conditions. The results show that the proposed method is robust against environmental noise and has good performance on wheeze detection. The approach has been implemented onto a PDA and tested with some real data. Keywords-Pulmonary sounds; Real-time classication; lung sound analysis; noise cancelation; wheezes; lung sounds;

I. I NTRODUCTION The breathing-associated sound heard on the chest of a person is called the lung sound [2]. Breathing sound and lung sound analysis to establish diagnoses is very interested in medicine. For example, with the invention of stethoscope the respiratory sounds heard over the chest wall have long been used as one of the means by which pulmonary dysfunctions were detected and diagnosed. Although auscultation by conventional stethoscope is an inexpensive and simple to use diagnostic method it has largely been restricted by subject dependency. Stethoscopes do not provide a frequencyindependent, uncolored transmission of sounds. They can selectively amplify or attenuate sounds within the spectrum of clinical interest [2]. It has also a high degree of subjectivity relative to the specialist [6]. However, recent advances in audio signal processing, and diagnostic algorithms have provided many efcient and effective research improvements to resurrect e-auscultation as an important diagnostic option. Sound signal digitization and processing techniques have been developed to make more objective the method by means of quantitative data. For instance, detection of wheeze by way of breathing sounds analysis has increased interest in recent years, since lung diseases are difcult to diagnose by X-ray machine and others medical instruments.
978-0-7695-3644-6/09 $25.00 2009 IEEE DOI 10.1109/P3644.17 10.1109/BSN.2009.18

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Figure 2.

System schematic

Figure 1.

Distributed Array of Microphones Experimental Setup

II. S YSTEM D ESCRIPTION : A. Distributed Array of Microphones Design The experimental setup of the wheeze detection system is shown in Figure 1. It consists of three modules: a distributed array of microphones, a front-end circuit and a PDA. The PDA is Hp iPAQ Hx2700 series and with the Intel PXA270 processor. The distributed array of microphones consist of two air-conductive and one bone-conductive microphone. The air-microphones(Panasonic WM-61B) have a at frequency response in frequency band of 20-5000Hz. The bone-microphone (BU-23173K, Knowles Acoustics) has at frequency response from 100Hz to 1000Hz. The detection process of the system is similar to the human auscultation. The distributed array of microphones record the breathing sounds. The array output is fed to a frontend circuit to amplify the signals of interest and suppress the unwanted interferences and noise. The processed signals are fed to the PDA to extract concerned parameters and produce a crude pattern which is analyzed, compared with stored thresholds. The result is displayed on the PDA. The picture of the front-end circuit is shown in Figure 2. In this study, multidimensional data are analyzed by a simple entropy based wheeze detection algorithm [16]. The thresholds are obtained from an adequate amount of training data. The acquisition of breath and lung sounds by array of microphones are taken with inpatients in stabilized respiratory conditions. Lung sound amplitude differs between persons and different locations on the chest surface [11]. The location of bone-conductive microphone in our study should be specied in order to record lung sound clearly. Further, to cancel the noise sound which is caused in auscultation through clothes, the bone-conductive microphone should be placed over the manubrium of the sternum in patients to record bronchial lung sound. It also should be touching the patients bare skin. The use of bone-conductive microphone can be found in [12]. The hardware solution was developed to improve
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the amplitude criteria were applied to the peaks of the spectrogram in order to discriminate the wheezing from the normal sounds. To improve the detection results, frequency and time continuity criteria were used at same time. The study in [9] developed an algorithm to detect wheezes at all sound levels and wheezing episodes with higher sensitivity. It eliminated the effect of patient-dependent transmission media. All of above mentioned works are conducted to improve the algorithms of detection wheeze in time and/or frequency domain. They achieved their best performance only when the noise condition of the test data matches that of the training data. It is not clear how well their technique will work in noisy environments. The main objective of our study is to develop a joint hardware and software solution to detect wheeze in noisy environment by use of a very simple classication algorithm. Continuing our previous work [1] on using a wearable microphone array system for health condition monitoring, this work is designed to make the detection system robust against environmental noise. The detection method is designed to operate at a sampling rate of 1000 Hz which is way below the typical sampling rate of 44 kHz for audio signals. The wheeze signal detector has been implemented on a PDA. In particular, the paper presents a hardware prototype that integrates two air-conductive microphones and one boneconductive microphone in acquisitions of breathing sounds and analyze automatically the respiratory sound generated by the wearer. The method intelligently fuses the output signals from the distributed array of microphones and extract the undistorted clean signals. Therefore, undistorted clean signals lead to much high detection accuracy in noisy environments.

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speech quality and combat against highly non-stationary acoustic noise, including background interfering speech. In our proposed study, the bone-conductive microphone is used to record the bronchial lung sounds through patients chest wall in noisy environment. B. Data Processing and Analysis The general system model is given in Figure 2. The signal y(t) captured by two air conductive microphone (a and b) consist of the clean breathing sound s(t) and noise n(t) which is caused by the environments and background speech. The signal is collected near to the patients neck, which is ya (t) = s(t) + na (t) yb (t) = s(t) + nb (t) (1)

2 Nabt (k) N (0, ab ) 2 Nbone (k) N (0, bone ).

(5)

The outputs of two air conductive microphones are fed to a beamformer where the unwanted interferences and noise are suppressed and the signals of interest are enhanced. The output of the beamformer is, yab (t) = s(t) + nab (t) (2)

The challenge of this study is to intelligently fuse two complementary signals to extract the useful undistorted clean breath signals with specied band width and distinct signal properties. These properties of captured sounds are most interested features in wheeze detection. The clean breath signal would not be available in the real detection process. The output sounds of the bone-conductive microphone and the beamformer are fused together to estimate the clean breathing sound. The estimation of clean breathing sound can be explored by an approach which fuses all available noisy measurements [13]. To estimate channel impulse response H, we use several frames of observation data. Let T be the number of frames used for estimation of H. To estimate clean breathing sound S, we only use one frame of observation data. The estimation of H and S are conducted by minimizing maximum likelihood estimation R=
T t=1 1 ( 22 |Yabt St | +
ab

1 2 2bone

|Bt HSt | ).

(6)

The lung sound recorded by the bone conductive microphone b(t) on the chest wall consists of clean breathing sound which is ltered by bone and tissues in the patients chest, and noise. b(t) = h(t) s(t) + nbone (t) (3)

Notice that St is complex variable, and R is a real function of the real part and imaginary part of St . Thus the partial derivatives of R with respect to the real part and imaginary part of R are zero at the optimum. By setting R =0 St we have, St =
2 2 bone Yabt + ab H Bt 2 2 bone + ab |H| 2

Where, h(t) is the impulse repones of the bone conductive microphone. The bone conductive microphone captures mostly the breathing sounds uttered by the patient but transmitted via the bone and tissues in the patients chest. Therefore, the external noise is heavily reduced in the bone signal. We can see the frequency spectral view of lung sounds in Figure 3. The sounds are captured from no-wheezy subject and wheezy patient. The main frequency components of the heart sound are in the range of 20-100Hz. The lung sound contains a much wider frequency range, which overlaps with the heart sound. In order to cancel heart sound in this study, the frequency component below 100Hz is ltered off from the captured lung sound and breathing sounds. In frequency domain, the output signals of the beamformer and bone sensor are represented as, Yabt (k) = St (k) + Nabt (k) Bt (k) = H(k)St (k) + Nbone (k) (4)

(7)

(8)

Substituting equation (8) to (6), we have

T

R=
t=1

|Bt HYabt |

2 2

2 2 bone + ab |H|

(9)

Here, R is regarded as a function of H and H . Then by setting R =0 H we obtain, H= where, p= q=

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Bt Yabt 2 2 ab |Bt | bone |Yabt | 2 2

(10)

2 2 q 2 + 4 |p| bone ab 2 2pbone

(11)

Where k is the frequency band and Yabt (k) is the kth frequency component of ym [n] = y[n]w[m n], windowed data around time t. We assume Nabt (k) and Nbone (k) are zero-mean Gaussian random variables

(12)

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E FFECT OF SNR

OF I NPUT

Table I S OUNDS ON W HEEZE D ETECTION

ACCURACY

SNR -5dB 0dB 5dB 10dB

Detection Accuracy (Wheeze) 85.7% 85.7% 92.8% 92.8%

Detection Accuracy (no-Wheeze) 84.2% 89.4% 94.7% 94.7%

Table II W HEEZE D ETECTION ACCURACY WITH /W ITHOUT B ONE C ONDUCTIVE M ICROPHONE , SNR=5 D B

Input Sound wheeze no-wheeze

Detection Accuracy (with Bone-Mic) 92.8% 94.7%

Detection Accuracy (without Bone-Mic) 71.4% 78.9%

Figure 3. The Frequency Spectral View (0-1Khz) of Lung Sounds from Top: a Healthy Subject and Bottom: a Wheezy Patient

Thus, the solutions for H and St can be obtained adaptively. III. P RELIMINARY R ESULTS AND D ISCUSSIONS In experiments, the lung sounds from fourteen patients and nineteen normal subjects are obtained from open resources that can be obtained online [14] [15]. It should be noted that, all tested data are re-sampled at the sampling rate of 1000Hz which is far below the original sampling rates. Table 1 shows the wheeze and no-wheezy sound detection results with the SNR at 5dB, 0dB, 5dB and 10dB, respectively. The rst column represents SNR values. The results of detection accuracy for wheeze sounds being feed to wheeze detection system are listed in the second column. The last column are the results of detection accuracy by feeding the no-wheezy breathing sounds into the system. We dene detection accuracy as the probability that the wheeze detection system makes the correct detection, or equivalently, the probability of error in the detection results. We can see that the detection accuracy for no-wheezy sounds with different SNR values are a little bit higher than wheeze sounds.
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The reason for higher accuracy of detection results in nowheezy sound could be interpreted from the point of view of abounding test data leading to more accurate classication threshold settings. Whereas, wheeze sounds have their spectrum changes from patient to patient, it is not easy to identify multiply changes through a simple classication method. To study further, let us compare the results in same column. No signicant differences were found among the results of detection accuracy which are obtained at different SNR. The results are less relevant to the SNR. In other words, the wheeze detection system are less sensitive to noise of surrounding environment. Table 2 shows the wheeze sound detection results with/without use of the bone sensor, respectively. The detection experiment is conducted at SNR= 5dB. The results of detection accuracy for wheeze sounds being feed to the system are listed in the second row. The last row are the results of no-wheezy breathing sounds. It is obvious that the results of detection accuracy for use of bone conductive microphone system are much higher than without use of bone microphone system. The simulation algorithms are developed in Matlab. For the method in this study, the detection process time is less than two seconds. In case of need, the detection system can be implemented and optimized for a much faster processor. IV. C ONCLUSION We presented a novel method to detect and analyze wheeze sounds. The method has a distributed microphone array and is able to operate at a sampling rate of 1000Hz. The investigation was to use two regular air conductive microphones and a bone conductive microphone to increase the accuracy of detection and make it robust against environmental noise. The two air-conductive microphones capture breathing sound while bone-conductive microphone record chest wall lung sound. The simulations were conducted using lung sounds from patients with wheezes and human

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subjects with no wheezes under different SNR conditions. The results show that the system is robust against environment noise and has good performance on wheeze detection. The proposed design has been implemented onto a PDA and tested with some real data. ACKNOWLEDGMENT This work was supported by the Embedded and Hybrid System (EHS) programme supported by the Agency for Science, Technology and Research (A*STAR) under the Grant 052-118-0053. R EFERENCES
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[11] N. Gavriely, Y. Palti, and G. Alroy, Spectral characteristics of normal breath sounds, J. Appl. Physiol., vol 50, pp 307 314, 1981. [12] Y. Zheng, Z. Liu, Z. Zhang, M. Sinclair, J. Droppo, L. Deng, A. Acero, Air-And Bone-Conductive Integrated Microphones for Robust Speech Detection and Enhancement, ASRU 2003, St. Thomas, U.S. Virgin Islands, Nov. 30 - Dec. 4, 2003. [13] Z. Liu, Z. Zhang, A. Acero, J. Droppo, and X. D. Huang, Direct ltering for air- and bone-conductive microphones, IEEE International Workshop on Multimedia Signal Processing (MMSP), Siena, Italy, 2004. [14] School of Medicine, University of California at Davis, Review of Lung Sounds, http://medocs.ucdavis.edu/IMD/420C/sounds/lngsound.htm. [15] P. Oleary, Abnormal Breath Sounds, http://mtsu32.mtsu.edu:11259/abnormal breath sounds.htm. [16] Jianmin Zhang, Wee Ser, Jufeng Yu, T. T. Zhang, A Novel Wheeze Detection Method for Wearable Monitoring Systems, submitted to International Symposium on Intelligent Ubiquitous Computing and Education, 2009.

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