Smith Jaclyn
Education and Research Centre, Academic Department of Medicine and Surgery, University of Manchester, Wythenshawe Hospital, Southmoor Rd, Wythenshawe, Manchester, M23 9LT, Manchester, UK.
Pulm Pharmacol Ther. 2007;20(4):313-8. doi: 10.1016/j.pupt.2006.10.016. Epub 2006 Nov 7.
Recording cough sounds to objectively quantify coughing was first performed using large reel-to-reel tape recorders more than 40 years ago. Coughs were counted manually, which is an extremely laborious and time-consuming process. Current technologies including digital recording techniques, data compression and improvements in digital storage capacity should make the process of recording and counting coughs suitable for automation; however, to date no accurate, objective cough monitoring device is available. Cough sounds are easily distinguishable from other vocalizations by the human ear and hence it is reasonable to assume that coughs sounds should have characteristic, identifying acoustic properties. However, the acoustic features of spontaneously occurring cough sounds are extremely variable. Furthermore, in even the worst cases of cough, the time spent speaking is an order of magnitude greater than the time spent coughing. It follows that even an algorithm that mistakes only a very small proportion of speech as cough will still have an unacceptable false positive rate. There is a clear need for an objective measure of cough for use in clinical practice, clinical research and trials of novel treatments. In the near future automated ambulatory systems with sufficient accuracy to be of clinical use should be available.
40多年前,人们首次使用大型盘式磁带录音机记录咳嗽声音,以客观量化咳嗽情况。咳嗽次数需人工计数,这是一个极其费力且耗时的过程。包括数字录音技术、数据压缩以及数字存储容量提升在内的现有技术,应能使咳嗽记录和计数过程实现自动化;然而,迄今为止,尚无准确、客观的咳嗽监测设备。人耳很容易将咳嗽声音与其他发声区分开来,因此可以合理推测咳嗽声音应具有特征性的识别声学特性。然而,自然发生的咳嗽声音的声学特征极具变异性。此外,即使在咳嗽最严重的情况下,说话时间也比咳嗽时间长一个数量级。由此可见,即使是一种仅将极小比例的语音误判为咳嗽的算法,其假阳性率仍将高得令人无法接受。显然需要一种用于临床实践、临床研究以及新型治疗试验的客观咳嗽测量方法。在不久的将来,有望出现具有足够准确性、可供临床使用的自动门诊系统。