Speaker-Disentangled Remote Speech Detection of Asthma and COPD Exacerbations
Authors: Yuyang Yan, Sami O. Simons, Visara Urovi
Organizations: Institute of Data Science, Maastricht University, Paul-Henri Spaaklaan 1, Maastricht, 6229 EN, the Netherlands · Department of Respiratory Medicine, NUTRIM Research Institute of Nutrition and Translational Research in Metabolism, Faculty of Health Medicine and Life Sciences, Maastricht University, P. Debyelaan 25, Maastricht, 6229 HX, the Netherlands · Department of Respiratory Medicine, Maastricht University Medical Centre, P. Debyelaan 25, Maastricht, 6229 HX, the Netherlands
Abstract
Early detection of exacerbations in asthma and chronic obstructive pulmonary disease (COPD) is important for timely intervention. Speech has emerged as a promising tool for continuous, non-invasive respiratory disease monitoring. However, speech signals inherently carry speaker-identifiable attributes that may dominate model predictions, which may compromise both diagnosis performance and patient privacy. Furthermore, the acoustic features associated with respiratory disease and speaker identity remain unclear in respiratory disease monitoring. We propose an adversarial learning architecture that disentangles pathology-related acoustic patterns from speaker-identifiable attributes. The framework optimizes two clinically hierarchical tasks: (i) respiratory status classification (stable vs. exacerbated) and (ii) exacerbation type classification (asthma exacerbation vs. COPD exacerbation). Speaker identity is suppressed through gradient reversal-based adversarial training. To enhance clinical interpretability, we employ SHapley Additive exPlanations (SHAP) to quantify the contributions of acoustic features to pathology-related predictions versus speaker identity. On the TACTICAS dataset, our method outperforms the single-task baseline across both tasks. For the respiratory status task (stable vs. exacerbated), the AUC improves from 0.897 to 0.910. For the exacerbation type task (asthma exacerbation vs. COPD exacerbation), the AUC increases from 0.674 to 0.793. Concurrently, the J-ratio decreases, confirming effective suppression of speaker information. SHAP analysis reveals the contributions of the acoustic features to both tasks. External validation on the Bridge2AI-Voice dataset further demonstrates consistent performance improvement and reduced speaker dependency, confirming cross-dataset generalizability.
Chronic Obstructive Pulmonary Disease (COPD) remains a major global health challenge, emphasizing the need for accessible and non-invasive detection. Since speech production is fundamentally linked to respiratory physiology, its disruptions can serve as indirect indicators of pulmonary impairment. This study introduces SpiroPhonia, a machine learning framework that leverages spontaneous speech for respiratory health assessment. We evaluated SpiroPhonia on a new dataset of 201 speakers (102 with COPD, 99 healthy controls). By integrating statistical analysis with recursive feature selection, we identified a compact set of discriminative speech markers. Our best model achieved 78% accuracy, 80% F1-score, and 87% AUC. This performance on spontaneous speech is competitive with methods using controlled laboratory recordings. Findings demonstrate that everyday speech encodes robust respiratory biomarkers, paving the way for continuous health monitoring via voice-enabled technologies.
Spontaneous speech offers a scalable, noninvasive signal for respiratory health assessment, yet interpretable models that generalize across languages remain challenging because disease-related acoustic changes are confounded by language-specific phonetic variation. We present CL-DAF, a Cross-Lingual Disease-Alignment Framework that identifies acoustic dimensions whose disease effects remain consistent across languages. Using 201 English and 75 newly collected Bangla speakers, we construct a common 272-dimensional acoustic representation and quantify disease alignment using signed rank-biserial effects and the Language Invariance Score. We first show that spontaneous Bangla speech separates COPD from controls (AUC 0.85); however, 133 features reverse their disease direction across languages and the full representation transfers poorly (AUC 0.49 from Bangla to English). CL-DAF isolates 26 disease-aligned features that raise AUCs to 0.825 and 0.722 from English to Bangla and Bangla to English, respectively. These findings provide a foundation for multilingual clinical speech models emphasizing pathology over language-dependent variation.
Roksana Khanom, Raghib Asfak Tasnim, Bodrun Nahar Bithi +4
This study aims to explore the performance of the VAR model in comparison with mel-frequency cepstral coefficient (MFCC) matrices and log-mel spectrograms using deep learning. In pulmonary sound classification, spectrogram-based representations suffer from inconsistent temporal dimensions due to varying respiratory cycle durations. Along with traditional trimming/zero-padding, adaptive-length windowing was presented to fix their temporal dimensions. Their spectral and temporal dimensions were optimized by testing a range of parameters. Different convolutional neural network (CNN) architectures were employed to extract features from the two-dimensional representations obtained over the sub-phases. The extracted sub-phase features were then fused using various strategies including direct concatenation, gated recurrent unit (GRU) network and GRU with attention mechanism. Model performances were assessed through respiratory cycle-based evaluation and subject-based evaluation comprising multiple respiratory cycles. Several data augmentation techniques were also studied to cope with limitations in data size. The best cycle-based F1-score (0.877) was obtained using the MFCC matrices with thirteen coefficients and 64-point time resolution per sub-phase representation followed by direct feature concatenation, and the best subject-based F1-score (0.855) was obtained using the MFCC matrices with thirteen coefficients and 256-point time resolution per full-cycle representation, both obtained by adaptive-length windowing. Augmentation degraded the performance of models overall, yet mixup augmentation was the best among the methods tested. MFCC outperformed log-mel spectrogram and VAR model in differentiation of asthma and COPD. Sophisticated fusion strategies did not improve the diagnosis. Augmentation did not contribute, demonstrating the significance of authentic data in pulmonary sound studies.