J Am Med Inform Assoc 20:e111-e117 doi:10.1136/amiajnl-2012-001171
  • Research and applications

Computer-aided diagnosis of pneumonia in patients with chronic obstructive pulmonary disease

  1. Sonia Astorga Moreno2
  1. 1Biomedical Engineering and Telemedicine Laboratory, Escuela Superior de Ingeniería, University of Cádiz, Cádiz, Spain
  2. 2Pulmonology and Allergy Unit, Puerta del Mar University Hospital, Cádiz, Spain
  1. Correspondence to Professor Daniel Sánchez Morillo, Dpto. de Ingeniería de Sistemas y Automática, Universidad de Cádiz—Escuela Superior de Ingeniería, Cádiz CP 11003, Spain; daniel.morillo{at}
  • Received 19 June 2012
  • Revised 16 January 2012
  • Accepted 17 January 2013
  • Published Online First 8 February 2013


Background Early diagnosis of pneumonia and discrimination between this disease and chronic obstructive pulmonary disease (COPD) exacerbations in patients with COPD are crucial for optimal clinical management and treatment.

Objectives To examine the use of computerized analysis of respiratory sounds, a hybrid system based on principal component analysis (PCA) and probabilistic neural networks (PNNs), to aid the detection of coexisting pneumonia in patients with COPD.

Methods and materials A convenience sample of 58 patients with COPD (25 patients hospitalized for community-acquired pneumonia and 33 owing to acute exacerbation of COPD) was studied. Auscultations were performed by the patients themselves on their suprasternal notch. Short-time Fourier transform analysis was used to extract features from the recorded respiratory sounds, PCA was selected for dimensionality reduction and a PNN was trained as classifier. 10-Fold cross-validation and receiver operating characteristic curve analysis were used to estimate the system performance.

Results Based on the cross-validation results, a sensitivity and a specificity of 72% and 81.8%, respectively, were achieved in validation data. The operating point was selected to maximize the specificity and sensitivity pair in the training set.

Discussion The results strongly suggest that electronic self-auscultation at a single location (suprasternal notch) can support diagnosis of pneumonia in patients with COPD.

Conclusions A simple, cost-effective method has been proposed to aid decision-making in areas with no radiological facilities available and in resource-constrained settings, and could have a great diagnostic impact on telemedicine applications.

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