An open access database for the evaluation of respiratory sound classification algorithms.

OBJECTIVE: Over the last few decades, there has been significant interest in the automatic analysis of respiratory sounds. However, currently there are no publicly available large databases with which new algorithms can be evaluated and compared. Further developments in the field are dependent on the creation of such databases. APPROACH: This paper describes a public respiratory sound database, which was compiled for an international competition, the first scientific challenge of the IFMBE's International Conference on Biomedical and Health Informatics. The database includes 920 recordings acquired from 126 participants and two sets of annotations. One set contains 6898 annotated respiratory cycles, some including crackles, wheezes, or a combination of both, and some with no adventitious respiratory sounds. In the other set, precise locations of 10 775 events of crackles and wheezes were annotated. MAIN RESULTS: The best system that participated in the challenge achieved an average score of 52.5% with the respiratory cycle annotations and an average score of 91.2% with the event annotations. SIGNIFICANCE: The creation and public release of this database will be useful to the research community and could bring attention to the respiratory sound classification problem.

COPD care delivery pathways in five European Union countries: mapping and health care professionals' perceptions.

BACKGROUND: COPD is among the leading causes of chronic morbidity and mortality in the European Union with an estimated annual economic burden of €25.1 billion. Various care pathways for COPD exist across Europe leading to different responses to similar problems. Determining these differences and the similarities may improve health and the functioning of health services. OBJECTIVE: The aim of this study was to compare COPD patients' care pathway in five European Union countries including England, Ireland, the Netherlands, Greece, and Germany and to explore health care professionals' (HCPs) perceptions about the current pathways. METHODS: HCPs were interviewed in two stages using a qualitative, semistructured email interview and a face-to-face semistructured interview. RESULTS: Lack of communication among different health care providers managing COPD and comorbidities was a common feature of the studied care pathways. General practitioners/family doctors are responsible for liaising between different teams/services, except in Greece where this is done through pulmonologists. Ireland and the UK are the only countries with services for patients at home to shorten unnecessary hospital stay. HCPs emphasized lack of communication, limited resources, and poor patient engagement as issues in the current pathways. Furthermore, no specified role exists for pharmacists and informal carers. CONCLUSION: Service and professional integration between care settings using a unified system targeting COPD and comorbidities is a priority. Better communication between health care providers, establishing a clear role for informal carers, and enhancing patients' engagement could optimize current care pathways resulting in a better integrated system.

Qualitative investigation into a wearable system for chronic obstructive pulmonary disease: the stakeholders' perspective.

OBJECTIVES: To ascertain the stakeholders' views and devise recommendations for further stages of the Wearable Sensing and Smart Cloud Computing for Integrated Care to Chronic Obstructive Pulmonary Disease (COPD) Patients with Co-morbidities (WELCOME) system development. This system aims to create a wearable vest to monitor physiological signals for patients concerned incorporating an inhaler adherence monitoring, weight, temperature, blood pressure and glucose metres, and a mobile health application for communication with healthcare professionals (HCPs). DESIGN: A study of qualitative data derived from focus groups and semistructured interviews. SETTING: 4 participating clinical sites in Greece, the UK, Ireland and the Netherlands. PARTICIPANTS: Purposive sampling was used to recruit 32 patients with COPD with heart failure, diabetes, anxiety or depression, 27 informal carers and 23 HCPs from 4 European Union (EU) countries for focus groups and interviews. RESULTS: Most patients and HCPs described the WELCOME system as 'brilliant and creative' and felt it gave a sense of safety. Both users and HCPs agreed that the duration and frequency of vest wear should be individualised as should the mobile application functions. The parameters and frequency of monitoring should be personalised using a multidisciplinary approach. A 'traffic light' alert system was proposed by HCPs for abnormal results. Patients were happy to take actions in response. CONCLUSIONS: WELCOME stakeholders provided valuable views on the development of the system, which should take into account patient's individual comorbidities, circumstances and concerns. This will enable the development of the individualised system in each member state concerned.

Subjective sleep quality in lung cancer patients before and after chemotherapy.

BACKGROUND: Sleep disturbances, such as difficulty in falling asleep, maintaining sleep, poor sleep efficiency, early awakening, and excessive daytime sleepiness, are common in patients with cancer. The aim of this study was to evaluate sleep characteristics in newly diagnosed lung cancer patients before and after three months of chemotherapy treatment. METHODS: Forty-nine patients with lung cancer, without brain metastasis, were included. Anthropometric and disease characteristics were collected. Upon diagnosis and after three months, a polysomnographic examination was conducted and the patients completed the Epworth Sleepiness Scale (ESS), the Pittsburgh Sleep Quality Index (PSQI), the Fatigue Severity Scale (FSS) and the Medical Research Council (MRC) dyspnoea scale. RESULTS: Before chemotherapy, the mean PSQI score was 7.1 ± 4, the FSS score was 3.92 ± 2, and the ESS score was 6.8 ± 4. The MRC score was low at 1.6 ± 1.1. A significant correlation between FSS and global PSQI was revealed (r = 0.424, P < 0.01), as well as with several of the PSQI components. After chemotherapy, no statistically significant change was observed in the PSQI (mean: 6.6 ± 4.5, t-score: 0.784, P = 0.438), or the FSS score (4.4 ± 2.2, t-score: -1.375, P = 0.177). Sleep efficiency was significantly reduced (P = 0.008), without any change in the distribution of sleep stages. CONCLUSION: The perception of sleep quality is poor among newly diagnosed lung cancer patients and is correlated with fatigue. After chemotherapy, self-reported sleep impairment is present and sleep efficiency is reduced, without significant change in sleep architecture.

Work productivity in obstructive sleep apnea patients.

OBJECTIVES: Purpose of the study was to assess work productivity in otherwise healthy obstructive sleep apnea (OSA) patients and to explore correlations between work productivity and different characteristics of OSA patients. METHODS: Work productivity was assessed by the Endicott Work Productivity Scale (EWPS) to 115 polysomnographically confirmed OSA patients of working age, without comorbidities. Daytime sleepiness was measured by the Epworth Sleepiness Scale. RESULTS: A significant correlation was revealed between EWPS and Epworth Sleepiness Scale scores (r2 = 0.127, P < 0.001). Mean EWPS score was significantly higher in somnolent versus nonsomnolent OSA patients (31.2 +/- 16.2 vs 20.8 +/- 11, respectively; P < 0.001). No other sleep or anthropometric characteristic correlated with EWPS. CONCLUSIONS: This study demonstrates the negative effect of daytime sleepiness on work productivity of otherwise healthy OSA patients, highlighting the need of screening for OSA and sleepiness among working individuals.