Lung-SRAD: Spectral-Aware Regularized Audio DASS with Dual-Axis Patch-Mix Contrastive Learning for Respiratory Sound Classification

AI-driven respiratory sound classification (RSC) is promising for automated pulmonary disease detection, yet multi-site deployment is hindered by inter-stethoscope variability. We introduce a federated domain generalization (FedDG) formulation for RSC under stethoscope-induced device shifts, where clients use heterogeneous devices and the model is evaluated on unseen devices. Our empirical analysis shows that stethoscope-induced style and disease-specific content are tightly entangled, making deterministic style removal unreliable. In response, we propose a causality-inspired multimodal FedDG framework that combines: (i) a causality-inspired device style intervention network that performs content-preserving style perturbations, (ii) counterfactual text augmentation that neutralizes metadata shortcuts, and (iii) gradient alignment that facilitates device-invariant representations across clients. Built on a multimodal language-audio pretraining model, it outperforms conventional data augmentation and federated learning baselines in leave-one-device-out validation on ICBHI and SPRSound datasets. Code will be released upon publication.

We present a quality-adaptive angular-margin learning framework that improves feature generalization by enforcing intra-class compactness and inter-class separability. Our framework, titled QLung, introduces a no-reference audio quality margin derived from spectral entropy and root-mean-square energy, which adaptively scales angular margins based on recording quality. To this end, we propose a log-scaled angular margin that stabilizes training under severe class imbalance. We also use an angular classifier that normalizes features and class weights, ensuring margin penalties are applied consistently on the unit hypersphere. Our approach improves in-distribution performance on the ICBHI dataset by 2.46% over the cross-entropy baseline, and most significantly, achieves the strongest out-of-distribution performance on the SPRSound dataset compared to prior state-of-the-art methods. Code is available at https://github.com/RSC-Toolkit/QLung.

Respiratory diseases remain a leading cause of global mortality, where timely and accurate diagnosis is critical to improving patient outcomes and reducing healthcare burdens. While prior work has explored audio-based models for respiratory disease detection, such unimodal approaches often suffer from limited generalizability and diagnostic precision. In this paper, we propose RespiraMFM, a Multimodal Foundation Model that integrates respiratory sounds with patient medical history and symptoms to enhance diagnostic accuracy and disease detection capabilities. We introduce an effective contrastive alignment strategy for audio-text multimodal integration, allowing the model to learn better cross-modal representations between respiratory sounds and corresponding textual clinical information. We evaluate RespiraMFM across five major respiratory diseases using seven real-world datasets in both supervised fine-tuning and zero-shot settings, achieving a 9.15% improvement in AUROC on supervised tasks and a 20.98% gain on zero-shot tasks over existing baselines. These findings underscore the potential of our framework to advance early diagnosis and improve clinical decision-making in respiratory disease management.