Adaptive Noise Suppression of Pediatric Lung Auscultations with Real Applications to Noisy Clinical Settings in Developing Countries

Goal: Chest auscultation constitutes a portable low-cost tool widely used for respiratory disease detection. Though it offers a powerful means of pulmonary examination, it remains riddled with a number of issues that limit its diagnostic capability. Particularly, patient agitation (especially in children), background chatter, and other environmental noises often contaminate the auscultation, hence affecting the clarity of the lung sound itself. This paper proposes an automated multiband denoising scheme for improving the quality of auscultation signals against heavy background contaminations. Methods: The algorithm works on a simple two-microphone setup, dynamically adapts to the background noise and suppresses contaminations while successfully preserving the lung sound content. The proposed scheme is refined to offset maximal noise suppression against maintaining the integrity of the lung signal, particularly its unknown adventitious components that provide the most informative diagnostic value during lung pathology. Results: The algorithm is applied to digital recordings obtained in the field in a busy clinic in West Africa and evaluated using objective signal fidelity measures and perceptual listening tests performed by a panel of licensed physicians. A strong preference of the enhanced sounds is revealed. Significance: The strengths and benefits of the proposed method lie in the simple automated setup and its adaptive nature, both fundamental conditions for everyday clinical applicability. It can be simply extended to a real-time implementation, and integrated with lung sound acquisition protocols.