Acoustic diagnosis of pulmonary hypertension: automated speech- recognition-inspired classification algorithm outperforms physicians.
We hypothesized that an automated speech- recognition-inspired classification algorithm could differentiate between the heart sounds in subjects with and without pulmonary hypertension (PH) and outperform physicians. Heart sounds, electrocardiograms, and mean pulmonary artery pressures (mPAp) were recorded simultaneously. Heart sound recordings were digitized to train and test speech-recognition-inspired classification algorithms. We used mel-frequency cepstral coefficients to extract features from the heart sounds. Gaussian-mixture models classified the features as PH (mPAp ≥ 25 mmHg) or normal (mPAp < 25 mmHg). Physicians blinded to patient data listened to the same heart sound recordings and attempted a diagnosis. We studied 164 subjects: 86 with mPAp ≥ 25 mmHg (mPAp 41 ± 12 mmHg) and 78 with mPAp < 25 mmHg (mPAp 17 ± 5 mmHg) (p  < 0.005). The correct diagnostic rate of the automated speech-recognition-inspired algorithm was 74% compared to 56% by physicians (p = 0.005). The false positive rate for the algorithm was 34% versus 50% (p = 0.04) for clinicians. The false negative rate for the algorithm was 23% and 68% (p = 0.0002) for physicians. We developed an automated speech-recognition-inspired classification algorithm for the acoustic diagnosis of PH that outperforms physicians that could be used to screen for PH and encourage earlier specialist referral.
Department of Electrical and Computer Engineering, University of Alberta, Edmonton, Canada.
Tarek
T
Kaddoura
Pediatric Pulmonary Hypertension Service, Pediatric Cardiac Critical Care Unit, Stollery Children's Hospital, Mazankowski Alberta Heart Institute, University of Alberta, Edmonton, Canada.
Karunakar
K
Vadlamudi
Pediatric Pulmonary Hypertension Service, Pediatric Cardiac Critical Care Unit, Stollery Children's Hospital, Mazankowski Alberta Heart Institute, University of Alberta, Edmonton, Canada.
Shine
S
Kumar
Pediatric Pulmonary Hypertension Service, Pediatric Cardiac Critical Care Unit, Stollery Children's Hospital, Mazankowski Alberta Heart Institute, University of Alberta, Edmonton, Canada.
Prashant
P
Bobhate
Pediatric Pulmonary Hypertension Service, Pediatric Cardiac Critical Care Unit, Stollery Children's Hospital, Mazankowski Alberta Heart Institute, University of Alberta, Edmonton, Canada.
Long
L
Guo
Pediatric Pulmonary Hypertension Service, Pediatric Cardiac Critical Care Unit, Stollery Children's Hospital, Mazankowski Alberta Heart Institute, University of Alberta, Edmonton, Canada.
Shreepal
S
Jain
Department Computing Science, University of Alberta, Edmonton, Canada.
Mohamed
M
Elgendi
Pediatric Pulmonary Hypertension Service, Pediatric Cardiac Critical Care Unit, Stollery Children's Hospital, Mazankowski Alberta Heart Institute, University of Alberta, Edmonton, Canada.
James Y
JY
Coe
Department of Medicine, Division of Cardiology, Cardiac Catheterization Laboratories, University of Alberta Hospital, Mazankowski Alberta Heart Institute, Edmonton, Canada.
Daniel
D
Kim
Department of Medicine, Division of Cardiology, Cardiac Catheterization Laboratories, University of Alberta Hospital, Mazankowski Alberta Heart Institute, Edmonton, Canada.
Dylan
D
Taylor
Department of Medicine, Division of Cardiology, Cardiac Catheterization Laboratories, University of Alberta Hospital, Mazankowski Alberta Heart Institute, Edmonton, Canada.
Wayne
W
Tymchak
Department Computing Science, University of Alberta, Edmonton, Canada.
Dale
D
Schuurmans
Department of Electrical and Computer Engineering, University of Alberta, Edmonton, Canada.
Roger J
RJ
Zemp
Pediatric Pulmonary Hypertension Service, Pediatric Cardiac Critical Care Unit, Stollery Children's Hospital, Mazankowski Alberta Heart Institute, University of Alberta, Edmonton, Canada.
Ian
I
Adatia
D000162:Acoustics; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000465:Algorithms; D002648:Child; D002675:Child, Preschool; D003936:Diagnosis, Computer-Assisted; D005260:Female; D006347:Heart Sounds; D006801:Humans; D006976:Hypertension, Pulmonary / Q000175:diagnosis*; D007223:Infant; D008297:Male; D008875:Middle Aged; D010820:Physicians; D012372:ROC Curve; D049250:Speech Recognition Software; D055815:Young Adult