AI-Based Classification of Pediatric Breath Sounds: Toward a Tool for Early Respiratory Screening
Source abstract
Abstract
Context: Respiratory morbidity is a leading cause of children’s consultations with general practitioners. Auscultation, the act of listening to breath sounds, is a crucial diagnostic method for respiratory system diseases. Problem: Parents and caregivers often lack the necessary knowledge and experience to identify subtle differences in children’s breath sounds. Furthermore, obtaining reliable feedback from young children about their physical condition is challenging. Methods: The use of a human–artificial intelligence (AI) tool is an essential component for screening and monitoring young children’s respiratory diseases. Using clinical data to design and validate the proposed approaches, we propose novel methods for recognizing and classifying children’s breath sounds. Different breath sound signals were analyzed in the time domain, frequency domain, and using spectrogram representations. Breath sound detection and segmentation were performed using digital signal processing techniques. Multiple features—including Mel–Frequency Cepstral Coefficients (MFCCs), Linear Prediction Coefficients (LPCs), Linear Prediction Cepstral Coefficients (LPCCs), spectral entropy, and Dynamic Linear Prediction Coefficients (DLPCs)—were extracted to capture both time and frequency characteristics. These features were then fed into various classifiers, including K-Nearest Neighbor (KNN), artificial neural networks (ANNs), hidden Markov models (HMMs), logistic regression, and decision trees, for recognition and classification. Main Findings: Experimental results from across 120 infants and preschoolers (2 months to 6 years) with respiratory disease (30 asthma, 30 croup, 30 pneumonia, and 30 normal) verified the performance of the proposed approaches. Conclusions: The proposed AI system provides a real-time diagnostic platform to improve clinical respiratory management and outcomes in young children, thereby reducing healthcare costs. Future work exploring additional respiratory diseases is warranted.
Source: crossref · Quality: baseline
Research context
OpenAlex topics: Phonocardiography and Auscultation Techniques · Respiratory and Cough-Related Research · Nursing Diagnosis and Documentation
SciVX discovery tags are terminology-based. OpenAlex topics are source-provided classifications.
Affiliations
Department of Electrical Engineering, Northern Illinois University, DeKalb, IL 60115, USA
Alexander Innovation Centre, Vancouver, BC V6B 1Y1, Canada
School of Nursing, Northern Illinois University, DeKalb, IL 60115, USA
References (50)
Show source-provided references
1. Jamison, D.T., Breman, J.G., Measham, A.R., Alleyne, G., Claeson, M., Evans, D.B., Jha, P., Mills, A., and Musgrove, P. (2018, May 06). Acute Respiratory Infections in Children, Disease Control Priorities in Developing Countries, Available online: https://www.ncbi.nlm.nih.gov/books/NBK11786/.
2. McCance, K., and Huether, S. (2020). Pathophysiology: The Biologic Basis for Disease in Adults and Children, Mosby Publish.
3. Children and Adolescents as Patients in General Practice—The Reasons for Encounter
4. Witt, W.P., Weiss, A.J., and Elixhauser, A. (2014). Overview of hospital stays for children in the United States, 2012. Healthcare Cost and Utilization Project (HCUP) Statistical Briefs, Agency for Healthcare Research and Quality (US).
5. Improving the efficiency of care for pediatric patients hospitalized with asthma10.1542/hpeds.2016-0108 ↗
6. Frey, U., and Gerritsen, J. (2006). Respiratory Diseases in Infants and Children, European Respiration Society Publication.10.1183/1025448x.erm3706 ↗
7. Parents’ responses to symptoms of respiratory tract infection in their children
8. Laennec, R.T.H. (1819). De l’Auscultation Mediate ou Traite du Diagnostic des Maladies des Poumons et du Coeur, Brosson and Chaude.
9. Fundamentals of lung auscultation10.1056/NEJMra1302901 ↗
10. The diagnostic accuracy of lung auscultation in adult patients with acute pulmonary pathologies: A meta-analysis10.1038/s41598-020-64405-6 ↗
11. Computerized respiratory sounds in patients with COPD: A systematic review10.3109/15412555.2014.908832 ↗
12. Respiratory sound analysis in the era of evidence-based medicine and the world of medicine 2.0
13. Representation and classification of breath sounds recorded in an intensive care setting using neural networks10.1023/A:1009934112185 ↗
14. Characteristics of breath sounds and adventitious respiratory sounds
15. Pramono, R.X.A., Bowyer, S., and Rodriguez-Villegas, E. (2017). Automatic adventitious respiratory sound analysis: A systematic review. PLoS ONE, 12.10.1371/journal.pone.0177926 ↗
16. Machine learning in lung sound analysis: A systematic review10.1016/j.bbe.2013.07.001 ↗
17. Computer-based respiratory sound analysis: A systematic review10.4103/0256-4602.113524 ↗
18. Computerized lung sound analysis as diagnostic aid for the detection of abnormal lung sounds: A systematic review and meta-analysis10.1016/j.rmed.2011.05.007 ↗
19. Auscultation of the respiratory system10.4103/1817-1737.160831 ↗
20. When a wheeze is not a wheeze: Acoustic analysis of breath sounds in infants10.1034/j.1399-3003.2000.16d04.x ↗
21. Validity and reliability of acoustic analysis of respiratory sounds in infants10.1136/adc.2003.046458 ↗
22. Current methods used for computerized respiratory sound analysis
23. Automated analysis of crackles in patients with interstitial pulmonary fibrosis
24. An Alternative Respiratory Sounds Classification System Utilizing Artificial Neural Networks10.4103/2319-4170.137773 ↗
25. Palaniappan, R., Sundaraj, K., and Lami, C.K. (2016, January 15–18). Reliable system for respiratory pathology classification from breath sound signals. Proceedings of the International Conference on System Reliability and Science (ICSRS), Paris, France.10.1109/ICSRS.2016.7815855 ↗
26. Snider, B., and Kaini, A. (2016, January 2–5). Automatic Classification of Breathing Sounds During Sleep. Proceedings of the 2016 International Conference on audio speech and signal processing (ICASSP), Izmir, Turkey.
27. A survey on automated wheeze detection systems for asthmatic patients
28. Signal domain in respiratory sound analysis: Methods, application and future development10.3844/jcssp.2015.1005.1016 ↗
29. Preferred reporting items for systematic reviews and meta-analyses: The PRISMA statement10.7326/0003-4819-151-4-200908180-00135 ↗
30. Spectral characteristics of chest wall breath sounds in normal subjects10.1136/thx.50.12.1292 ↗
31. Artificial intelligence accuracy in detecting pathological breath sounds in children using digital stethoscopes10.1186/s12931-020-01523-9 ↗
32. Kim, B.J., Kim, B.S., Mun, J.H., Lim, C., and Kim, K. (2022). An accurate deep learning model for wheezing in children using real world data. Sci. Rep., 12.10.1038/s41598-022-25953-1 ↗
33. Park, J.S., Kim, K., Kim, J.H., Choi, Y.J., Kim, K., and Suh, D.I. (2023). A machine learning approach to the development and prospective evaluation of a pediatric lung sound classification model. Sci. Rep., 13.10.1038/s41598-023-27399-5 ↗
34. Automated Interpretation of Lung Sounds by Deep Learning in Children With Asthma: Scoping Review and Strengths, Weaknesses, Opportunities, and Threats Analysis10.2196/53662 ↗
35. Mochizuki, H., Hirai, K., Furuya, H., Niimura, F., Suzuki, K., Okino, T., Ikeda, M., and Noto, H. (2024). The analysis of lung sounds in infants and children with a history of wheezing/asthma using an automatic procedure. BMC Pulm. Med., 24.10.1186/s12890-024-03210-7 ↗
36. Machine learning-driven strategies for enhanced pediatric wheezing detection10.3389/fped.2025.1428862 ↗
37. Spectral entropy analysis of the respiratory signal and its relationship with the cyclic alternating pattern during sleep10.1142/S0129183116501400 ↗
38. Rizal, A., Hidayat, R., and Nugroho, H.A. (2017, January 26–28). Entropy measurement as features extraction in automatic lung sound classification. Proceedings of the International Conference on Control, Electronics, Renewable Energy and Communications (ICCREC), Yogyakarta, Indonesia.10.1109/ICCEREC.2017.8226668 ↗
39. Lung Sound Classification Using Wavelet Transform and Entropy to Detect Lung Abnormality10.2298/SJEE2201079R ↗
40. Liu, L., Li, W., and Jiang, C. (2021, January 17–20). Applying Time-varying Features in Children Respiratory Recognition and Classification for Respiration System Diseases Screening. Proceedings of the IEEE International Conference on Systems, Man, and Cybernetics, Melbourne, Australia.10.1109/SMC52423.2021.9659096 ↗
41. Liu, L., Li, W., and Jiang, C. (2019, January 20–24). Breath Sounds Recognition and Classification for Respiration System Diseases. Proceedings of the IEEE International Conference on Communications (ICC), Shanghai, China.
42. Method for automatic detection of wheezing in lung sounds10.1590/S0100-879X2009000700013 ↗
43. Frey, U., and Gerritsen, J. (2015). New CDC Study Highlights Burden of Pneumonia Hospitalizations on U.S. Children, Center for Disease Control and Prevention.
44. Adderley, N., Goldin, J., and Sharma, S. (2025). Pleural Friction Rub. StatPearls, StatPearls Publishing.
45. Frey, U., and Gerritsen, J. (2016). Chronic Obstructive Pulmonary Disease (COPD) Includes: Chronic Bronchitis and Emphysema, Center for Disease Control and Prevention.
46. Kondoz, A.M. (2004). Digital Speech, John Wiley & Sons Ltd.10.1002/0470870109 ↗
47. Design analysis and experimental evaluation of block based transformation in MFCC computation for speaker recognition10.1016/j.specom.2011.11.004 ↗
48. Time-varying autoregressive modeling of speech10.1016/0165-1684(83)90074-9 ↗
49. Oliver, K. (2013). K-nearest neighbors. Dimensionality Reduction with Unsupervised Nearest Neighbors, Springer.
50. Ham, F.M., and Kostanic, I. (2001). Principles of Neurocomputing for Science and Engineering, McGraw-Hill.