George P. Kafentzis

George P. Kafentzis, Stephane Tetsing, Joe Brew et al.

Tuberculosis (TB) is an infectious disease caused by the bacterium Mycobacterium tuberculosis and primarily affects the lungs, as well as other body parts. TB is spread through the air when an infected person coughs, sneezes, or talks. Medical doctors diagnose TB in patients via clinical examinations and specialized tests. However, coughing is a common symptom of respiratory diseases such as TB. Literature suggests that cough sounds coming from different respiratory diseases can be distinguished by both medical doctors and computer algorithms. Therefore, cough recordings associated with patients with and without TB seems to be a reasonable avenue of investigation. In this work, we utilize a very large dataset of TB and non-TB cough audio recordings obtained from the south-east of Africa, India, and the south-east of Asia using a fully automated phone-based application (Hyfe), without manual annotation. We fit statistical classifiers based on spectral and time domain features with and without clinical metadata. A stratified grouped cross-validation approach shows that an average Area Under Curve (AUC) of approximately 0.70 $\pm$ 0.05 both for a cough-level and a participant-level classification can be achieved using cough sounds alone. The addition of demographic and clinical factors increases performance, resulting in an average AUC of approximately 0.81 $\pm$ 0.05. Our results suggest mobile phone-based applications that integrate clinical symptoms and cough sound analysis could help community health workers and, most importantly, health service programs to improve TB case-finding efforts while reducing costs, which could substantially improve public health.

George P. Kafentzis, Efstratios Selisios

In this paper, we propose a standardized framework for automatic tuberculosis (TB) detection from cough audio and routinely collected clinical data using machine learning. While TB screening from audio has attracted growing interest, progress is difficult to measure because existing studies vary substantially in datasets, cohort definitions, feature representations, model families, validation protocols, and reported metrics. Consequently, reported gains are often not directly comparable, and it remains unclear whether improvements stem from modeling advances or from differences in data and evaluation. We address this gap by establishing a strong, well-documented baseline for TB prediction using cough recordings and accompanying clinical metadata from a recently compiled dataset from several countries. Our pipeline is reproducible end-to-end, covering feature extraction, multimodal fusion, cougher-independent evaluation, and uncertainty quantification, and it reports a consistent suite of clinically relevant metrics to enable fair comparison. We further quantify performance for cough audio-only and fused (audio + clinical metadata) models, and release the full experimental protocol to facilitate benchmarking. This baseline is intended to serve as a common reference point and to reduce methodological variance that currently holds back progress in the field.

Alexander Philip, Sanya Chawla, Lola Jover et al.

Chest X-ray is a commonly used tool during triage, diagnosis and management of respiratory diseases. In resource-constricted settings, optimizing this resource can lead to valuable cost savings for the health care system and the patients as well as to and improvement in consult time. We used prospectively-collected data from 137 patients referred for chest X-ray at the Christian Medical Center and Hospital (CMCH) in Purnia, Bihar, India. Each patient provided at least five coughs while awaiting radiography. Collected cough sounds were analyzed using acoustic AI methods. Cross-validation was done on temporal and spectral features on the cough sounds of each patient. Features were summarized using standard statistical approaches. Three models were developed, tested and compared in their capacity to predict an abnormal result in the chest X-ray. All three methods yielded models that could discriminate to some extent between normal and abnormal with the logistic regression performing best with an area under the receiver operating characteristic curves ranging from 0.7 to 0.78. Despite limitations and its relatively small sample size, this study shows that AI-enabled algorithms can use cough sounds to predict which individuals presenting for chest radiographic examination will have a normal or abnormal results. These results call for expanding this research given the potential optimization of limited health care resources in low- and middle-income countries.