Igor D. S. Miranda

Madhurananda Pahar, Igor Miranda, Andreas Diacon et al.

We present a new machine learning based bed-occupancy detection system that uses the accelerometer signal captured by a bed-attached consumer smartphone. Automatic bed-occupancy detection is necessary for automatic long-term cough monitoring, since the time which the monitored patient occupies the bed is required to accurately calculate a cough rate. Accelerometer measurements are more cost effective and less intrusive than alternatives such as video monitoring or pressure sensors. A 249-hour dataset of manually-labelled acceleration signals gathered from seven patients undergoing treatment for tuberculosis (TB) was compiled for experimentation. These signals are characterised by brief activity bursts interspersed with long periods of little or no activity, even when the bed is occupied. To process them effectively, we propose an architecture consisting of three interconnected components. An occupancy-change detector locates instances at which bed occupancy is likely to have changed, an occupancy-interval detector classifies periods between detected occupancy changes and an occupancy-state detector corrects falsely-identified occupancy changes. Using long short-term memory (LSTM) networks, this architecture was demonstrated to achieve an AUC of 0.94. When integrated into a complete cough monitoring system, the daily cough rate of a patient undergoing TB treatment was determined over a period of 14 days. As the colony forming unit (CFU) counts decreased and the time to positivity (TPP) increased, the measured cough rate decreased, indicating effective TB treatment. This provides a first indication that automatic cough monitoring based on bed-mounted accelerometer measurements may present a non-invasive, non-intrusive and cost-effective means of monitoring long-term recovery of TB patients.

Madhurananda Pahar, Igor Miranda, Andreas Diacon et al.

We have performed cough detection based on measurements from an accelerometer attached to the patient's bed. This form of monitoring is less intrusive than body-attached accelerometer sensors, and sidesteps privacy concerns encountered when using audio for cough detection. For our experiments, we have compiled a manually-annotated dataset containing the acceleration signals of approximately 6000 cough and 68000 non-cough events from 14 adult male patients in a tuberculosis clinic. As classifiers, we have considered convolutional neural networks (CNN), long-short-term-memory (LSTM) networks, and a residual neural network (Resnet50). We find that all classifiers are able to distinguish between the acceleration signals due to coughing and those due to other activities including sneezing, throat-clearing and movement in the bed with high accuracy. The Resnet50 performs the best, achieving an area under the ROC curve (AUC) exceeding 0.98 in cross-validation experiments. We conclude that high-accuracy cough monitoring based only on measurements from the accelerometer in a consumer smartphone is possible. Since the need to gather audio is avoided and therefore privacy is inherently protected, and since the accelerometer is attached to the bed and not worn, this form of monitoring may represent a more convenient and readily accepted method of long-term patient cough monitoring.