Department of Electronic, Information and Bioengineering, Politecnico di Milano University, Milan, Italy.
Department of Electronic, Information and Bioengineering, Politecnico di Milano University, Milan, Italy.
Comput Biol Med. 2021 Nov;138:104871. doi: 10.1016/j.compbiomed.2021.104871. Epub 2021 Sep 14.
The forced oscillation technique (FOT) allows non-invasive lung function testing during quiet breathing even without expert guidance. However, it still relies on an operator for excluding breaths with artefacts such as swallowing, glottis closure and coughing. This manual selection is operator-dependent and time-consuming. We evaluated supervised machine learning methods to exclude breaths with artefacts from data analysis automatically.
We collected 932 FOT measurements (Resmon Pro Full, Restech) from 155 patients (6-87 years) following the European Respiratory Society (ERS) technical standards. Patients were randomly assigned to either a training (70%) or test set. For each breath, we computed 71 features (including anthropometric, pressure stimulus, breathing pattern, and oscillometry data). Univariate filter, multivariate filter and wrapper methods for feature selection combined with several classification models were considered.
Trained operators identified 4333 breaths with- and 10244 without artefacts. Features selection performed by a wrapper method combined with an AdaBoost tree model provided the best performance metrics on the test set: Balanced Accuracy = 85%; Sensitivity = 79%; Specificity = 91%; AUC-ROC = 0.93. Differences in FOT parameters computed after manual or automatic breath selection was less than ∼0.25 cmHO*s/L for 95% of cases.
Supervised machine-learning techniques allow reliable artefact detection in FOT diagnostic tests. Automating this process is fundamental for enabling FOT for home monitoring, telemedicine, and point-of-care diagnostic applications and opens new scenarios for respiratory and community medicine.
强迫震荡技术(FOT)允许在安静呼吸时进行非侵入性肺功能测试,即使没有专家指导也是如此。但是,它仍然依赖于操作者来排除存在伪迹的呼吸,例如吞咽、声门关闭和咳嗽。这种手动选择依赖于操作者,并且很耗时。我们评估了监督机器学习方法,以便自动从数据分析中排除存在伪迹的呼吸。
我们按照欧洲呼吸学会(ERS)技术标准,从 155 名患者(6-87 岁)中收集了 932 次 FOT 测量值(Resmon Pro Full,Restech)。患者被随机分配到训练集(70%)或测试集。对于每个呼吸,我们计算了 71 个特征(包括人体测量学、压力刺激、呼吸模式和震荡测量数据)。我们考虑了用于特征选择的单变量过滤器、多变量过滤器和包装器方法,以及几种分类模型。
经过训练的操作人员识别出了 4333 次存在伪迹的呼吸和 10244 次无伪迹的呼吸。包装器方法与 AdaBoost 树模型相结合进行的特征选择在测试集上提供了最佳的性能指标:平衡准确性=85%;敏感性=79%;特异性=91%;AUC-ROC=0.93。在手动或自动呼吸选择后计算的 FOT 参数之间的差异在 95%的情况下小于约 0.25 cmHO*s/L。
监督机器学习技术允许在 FOT 诊断测试中可靠地检测伪迹。使这个过程自动化对于实现 FOT 在家庭监测、远程医疗和即时诊断应用中的应用至关重要,并为呼吸和社区医学开辟了新的场景。