June-Woo Kim

June-Woo Kim, Chihyeon Yoon, Miika Toikkanen et al.

Deep generative models have emerged as a promising approach in the medical image domain to address data scarcity. However, their use for sequential data like respiratory sounds is less explored. In this work, we propose a straightforward approach to augment imbalanced respiratory sound data using an audio diffusion model as a conditional neural vocoder. We also demonstrate a simple yet effective adversarial fine-tuning method to align features between the synthetic and real respiratory sound samples to improve respiratory sound classification performance. Our experimental results on the ICBHI dataset demonstrate that the proposed adversarial fine-tuning is effective, while only using the conventional augmentation method shows performance degradation. Moreover, our method outperforms the baseline by 2.24% on the ICBHI Score and improves the accuracy of the minority classes up to 26.58%. For the supplementary material, we provide the code at https://github.com/kaen2891/adversarial_fine-tuning_using_generated_respiratory_sound.

Hemansh Shridhar, Miika Toikkanen, June-Woo Kim

Recent respiratory sound classification (RSC) studies largely rely on CLS-token driven self-attention architectures such as the Audio Spectrogram Transformer (AST). While effective at modeling global context, recent analyses suggest a low-pass filtering behavior that may reduce sensitivity to localized abnormal patterns. In this work, we investigate State Space Models (SSMs) as an alternative backbone for RSC. Using the Distilled Audio State Space model, we analyze intermediate representations through spectral response curves and observe stronger preservation of mid-to-high spatial-frequency components. Based on these observations, we introduce spectral-aware layer regularization using Gaussian convolution applied to selected layers. We further propose Dual-Axis Patch-Mix contrastive learning tailored to SSM-based audio models for robust representation learning. Experiments on the ICBHI benchmark show that our approach achieves 64.48% score, outperforming the AST baseline by 5%. Code is available at https://github.com/RSC-Toolkit/Lung-SRAD.

Yoon Tae Kim, Heejoon Koo, Miika Toikkanen et al.

We present a quality-adaptive angular-margin learning framework that improves feature generalization by enforcing intra-class compactness and inter-class separability. Our framework, titled QLung, introduces a no-reference audio quality margin derived from spectral entropy and root-mean-square energy, which adaptively scales angular margins based on recording quality. To this end, we propose a log-scaled angular margin that stabilizes training under severe class imbalance. We also use an angular classifier that normalizes features and class weights, ensuring margin penalties are applied consistently on the unit hypersphere. Our approach improves in-distribution performance on the ICBHI dataset by 2.46\% over the cross-entropy baseline, and most significantly, achieves the strongest out-of-distribution performance on the SPRSound dataset compared to prior state-of-the-art methods. Code is available at https://github.com/RSC-Toolkit/QLung.

June-Woo Kim, Miika Toikkanen, Heejoon Koo et al.

Training reliable respiratory sound classification models remains challenging due to the limited size and subject diversity of datasets. Ensemble methods can improve robustness, but when base models are trained on identical data, models tend to overfit and produce highly correlated predictions, thereby reducing the effectiveness of ensembling. In this work, we investigate a meta-ensemble learning methodology that enhances prediction diversity by training base models on diverse data splits and combining their outputs through a trained meta-model. Specifically, we train base models on the ICBHI dataset using two data split settings: fixed 80-20% split and five-fold cross-validation split, under two data granularity settings: patient- and sample-level. The resulting diversity in base model predictions enables the meta-model to better generalize. Our approach achieves new state-of-the-art performance on the ICBHI benchmark, reaching a Score of 66.49% and showing improved generalization on two out-of-distribution datasets, indicating its potential applicability to real-world clinical data.

June-Woo Kim, Kangwook Jang, Minu Kim et al.

Ambulatory neck-surface acceleration enables non-invasive monitoring of vocal hyperfunction, yet robust biomarkers for its subtypes remain limited. This study investigates the NeckVibe Challenge dataset to distinguish phonotraumatic (PVH) and non-phonotraumatic (NPVH) from healthy controls. We propose a hierarchical feature engineering framework comprising: (i) static, (ii) dynamic, (iii) ratio-based, (iv) coupling features capturing source filter interactions. While univariate statistical analysis shows strong separability for PVH but limited significance for NPVH, our machine learning pipeline, tailored for high-dimensional feature integration, identifies that coupling features are crucial for both tasks. We achieve an AUC of 0.891 for PVH and 0.728 for NPVH, suggesting that while PVH is near-linearly separable, NPVH discrimination benefits from modeling non-linear feature interactions.

Heejoon Koo, Yoon Tae Kim, Miika Toikkanen et al.

AI-driven respiratory sound classification (RSC) is promising for automated pulmonary disease detection, yet multi-site deployment is hindered by inter-stethoscope variability. We introduce a federated domain generalization (FedDG) formulation for RSC under stethoscope-induced device shifts, where clients use heterogeneous devices and the model is evaluated on unseen devices. Our empirical analysis shows that stethoscope-induced style and disease-specific content are tightly entangled, making deterministic style removal unreliable. In response, we propose a causality-inspired multimodal FedDG framework that combines: (i) a causality-inspired device style intervention network that performs content-preserving style perturbations, (ii) counterfactual text augmentation that neutralizes metadata shortcuts, and (iii) gradient alignment that facilitates device-invariant representations across clients. Built on a multimodal language-audio pretraining model, it outperforms conventional data augmentation and federated learning baselines in leave-one-device-out validation on ICBHI and SPRSound datasets. Code will be released upon publication.

June-Woo Kim, Dhruv Agarwal, Federica Cerina

Objective evaluation of synthetic speech quality remains a critical challenge. Human listening tests are the gold standard, but costly and impractical at scale. Fréchet Distance has emerged as a promising alternative, yet its reliability depends heavily on the choice of embeddings and experimental settings. In this work, we comprehensively evaluate Fréchet Speech Distance (FSD) and its variant Speech Maximum Mean Discrepancy (SMMD) under varied embeddings and conditions. We further incorporate human listening evaluations alongside TTS intelligibility and synthetic-trained ASR WER to validate the perceptual relevance of these metrics. Our findings show that WavLM Base+ features yield the most stable alignment with human ratings. While FSD and SMMD cannot fully replace subjective evaluation, we show that they can serve as complementary, cost-efficient, and reproducible measures, particularly useful when large-scale or direct listening assessments are infeasible. Code is available at https://github.com/kaen2891/FrechetSpeechDistance.

June-Woo Kim, Sangmin Bae, Won-Yang Cho et al.

Despite the remarkable advances in deep learning technology, achieving satisfactory performance in lung sound classification remains a challenge due to the scarcity of available data. Moreover, the respiratory sound samples are collected from a variety of electronic stethoscopes, which could potentially introduce biases into the trained models. When a significant distribution shift occurs within the test dataset or in a practical scenario, it can substantially decrease the performance. To tackle this issue, we introduce cross-domain adaptation techniques, which transfer the knowledge from a source domain to a distinct target domain. In particular, by considering different stethoscope types as individual domains, we propose a novel stethoscope-guided supervised contrastive learning approach. This method can mitigate any domain-related disparities and thus enables the model to distinguish respiratory sounds of the recording variation of the stethoscope. The experimental results on the ICBHI dataset demonstrate that the proposed methods are effective in reducing the domain dependency and achieving the ICBHI Score of 61.71%, which is a significant improvement of 2.16% over the baseline.

June-Woo Kim, Miika Toikkanen, Sangmin Bae et al.

Recent advancements in AI have democratized its deployment as a healthcare assistant. While pretrained models from large-scale visual and audio datasets have demonstrably generalized to this task, surprisingly, no studies have explored pretrained speech models, which, as human-originated sounds, intuitively would share closer resemblance to lung sounds. This paper explores the efficacy of pretrained speech models for respiratory sound classification. We find that there is a characterization gap between speech and lung sound samples, and to bridge this gap, data augmentation is essential. However, the most widely used augmentation technique for audio and speech, SpecAugment, requires 2-dimensional spectrogram format and cannot be applied to models pretrained on speech waveforms. To address this, we propose RepAugment, an input-agnostic representation-level augmentation technique that outperforms SpecAugment, but is also suitable for respiratory sound classification with waveform pretrained models. Experimental results show that our approach outperforms the SpecAugment, demonstrating a substantial improvement in the accuracy of minority disease classes, reaching up to 7.14%.

June-Woo Kim, Haram Yoon, Wonkyo Oh et al.

Speech-based AI models are emerging as powerful tools for detecting depression and the presence of Post-traumatic stress disorder (PTSD), offering a non-invasive and cost-effective way to assess mental health. However, these models often struggle with gender bias, which can lead to unfair and inaccurate predictions. In this study, our study addresses this issue by introducing a domain adversarial training approach that explicitly considers gender differences in speech-based depression and PTSD detection. Specifically, we treat different genders as distinct domains and integrate this information into a pretrained speech foundation model. We then validate its effectiveness on the E-DAIC dataset to assess its impact on performance. Experimental results show that our method notably improves detection performance, increasing the F1-score by up to 13.29 percentage points compared to the baseline. This highlights the importance of addressing demographic disparities in AI-driven mental health assessment.

June-Woo Kim, Sanghoon Lee, Miika Toikkanen et al.

Auscultation remains a cornerstone of clinical practice, essential for both initial evaluation and continuous monitoring. Clinicians listen to the lung sounds and make a diagnosis by combining the patient's medical history and test results. Given this strong association, multitask learning (MTL) can offer a compelling framework to simultaneously model these relationships, integrating respiratory sound patterns with disease manifestations. While MTL has shown considerable promise in medical applications, a significant research gap remains in understanding the complex interplay between respiratory sounds, disease manifestations, and patient metadata attributes. This study investigates how integrating MTL with cutting-edge deep learning architectures can enhance both respiratory sound classification and disease diagnosis. Specifically, we extend recent findings regarding the beneficial impact of metadata on respiratory sound classification by evaluating its effectiveness within an MTL framework. Our comprehensive experiments reveal significant improvements in both lung sound classification and diagnostic performance when the stethoscope information is incorporated into the MTL architecture.

Myeonghoon Ryu, June-Woo Kim, Minseok Oh et al.

Keyword spotting is often implemented by keyword classifier to the encoder in acoustic models, enabling the classification of predefined or open vocabulary keywords. Although keyword spotting is a crucial task in various applications and can be extended to call-for-help detection in emergencies, however, the previous method often suffers from scalability limitations due to retraining required to introduce new keywords or adapt to changing contexts. We explore a simple yet effective approach that leverages off-the-shelf pretrained ASR models to address these challenges, especially in call-for-help detection scenarios. Furthermore, we observed a substantial increase in false alarms when deploying call-for-help detection system in real-world scenarios due to noise introduced by microphones or different environments. To address this, we propose a novel noise-agnostic multitask learning approach that integrates a noise classification head into the ASR encoder. Our method enhances the model's robustness to noisy environments, leading to a significant reduction in false alarms and improved overall call-for-help performance. Despite the added complexity of multitask learning, our approach is computationally efficient and provides a promising solution for call-for-help detection in real-world scenarios.

Miika Toikkanen, June-Woo Kim

Respiratory sound datasets are limited in size and quality, making high performance difficult to achieve. Ensemble models help but inevitably increase compute cost at inference time. Soft label training distills knowledge efficiently with extra cost only at training. In this study, we explore soft labels for respiratory sound classification as an architecture-agnostic approach to distill an ensemble of teacher models into a student model. We examine different variations of our approach and find that even a single teacher, identical to the student, considerably improves performance beyond its own capability, with optimal gains achieved using only a few teachers. We achieve the new state-of-the-art Score of 64.39 on ICHBI, surpassing the previous best by 0.85 and improving average Scores across architectures by more than 1.16. Our results highlight the effectiveness of knowledge distillation with soft labels for respiratory sound classification, regardless of size or architecture.

June-Woo Kim, Miika Toikkanen, Yera Choi et al.

Respiratory sound classification (RSC) is challenging due to varied acoustic signatures, primarily influenced by patient demographics and recording environments. To address this issue, we introduce a text-audio multimodal model that utilizes metadata of respiratory sounds, which provides useful complementary information for RSC. Specifically, we fine-tune a pretrained text-audio multimodal model using free-text descriptions derived from the sound samples' metadata which includes the gender and age of patients, type of recording devices, and recording location on the patient's body. Our method achieves state-of-the-art performance on the ICBHI dataset, surpassing the previous best result by a notable margin of 1.17%. This result validates the effectiveness of leveraging metadata and respiratory sound samples in enhancing RSC performance. Additionally, we investigate the model performance in the case where metadata is partially unavailable, which may occur in real-world clinical setting.

Sangmin Bae, June-Woo Kim, Won-Yang Cho et al.

Respiratory sound contains crucial information for the early diagnosis of fatal lung diseases. Since the COVID-19 pandemic, there has been a growing interest in contact-free medical care based on electronic stethoscopes. To this end, cutting-edge deep learning models have been developed to diagnose lung diseases; however, it is still challenging due to the scarcity of medical data. In this study, we demonstrate that the pretrained model on large-scale visual and audio datasets can be generalized to the respiratory sound classification task. In addition, we introduce a straightforward Patch-Mix augmentation, which randomly mixes patches between different samples, with Audio Spectrogram Transformer (AST). We further propose a novel and effective Patch-Mix Contrastive Learning to distinguish the mixed representations in the latent space. Our method achieves state-of-the-art performance on the ICBHI dataset, outperforming the prior leading score by an improvement of 4.08%.

Myungsu Chae, Tae-Ho Kim, Young Hoon Shin et al.

Multi-task learning is a method for improving the generalizability of multiple tasks. In order to perform multiple classification tasks with one neural network model, the losses of each task should be combined. Previous studies have mostly focused on multiple prediction tasks using joint loss with static weights for training models, choosing the weights between tasks without making sufficient considerations by setting them uniformly or empirically. In this study, we propose a method to calculate joint loss using dynamic weights to improve the total performance, instead of the individual performance, of tasks. We apply this method to design an end-to-end multimodal emotion and gender recognition model using audio and video data. This approach provides proper weights for the loss of each task when the training process ends. In our experiments, emotion and gender recognition with the proposed method yielded a lower joint loss, which is computed as the negative log-likelihood, than using static weights for joint loss. Moreover, our proposed model has better generalizability than other models. To the best of our knowledge, this research is the first to demonstrate the strength of using dynamic weights for joint loss for maximizing overall performance in emotion and gender recognition tasks.