The need for standards in recording and analysing respiratory sounds

  • M. J. Mussell


Respiratory sounds (RSs) recorded from the chest and trachea are nowadays being electronically analysed by many investigators with a view to (i) determining the mechanisms of their production, and (ii) to develop automated diagnostic systems based on RS analysis, that objectively categorise RS as being associated with health or respiratory diseases. However, one problem that hampers this type of research is that almost every RS investigation team uses different equipment, protocols and analysis methods which, to varying degrees, makes inter-investigator results difficult to compare. The review first discusses the many variables involved in RS recording and analysis, and the different approaches used by different investigators, to highlight this problem and its consequences. Secondly, although the review cannot propose immediately acceptable guidelines and standards for RS analysis, it proposes a ‘seed’ set of guidelines that are ‘up for discussion’ between investigators in the field, the final goal being to inject a degree of standardisation in equipment and methods that are acceptable to all involved.


Auscultation Breathing sounds Fast Fourier transform Lung sounds Respiratory sounds 


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  1. Banham, S. W., Urquhart, R. B., Macleod, J. E. S. andMoran, F. (1984) Alteration in the low-frequency lung sounds in respiratory disorders associated with crackles.Eur. J. Respirat. Dis.,65, 58–63.Google Scholar
  2. Baughman, R. P. andLouden, R. G. (1984) Quantization of wheezing in acute asthma.Chest,5, 718–722.Google Scholar
  3. Bendat, J. S. andPiersol, A. G. (1986)Random data: analysis and measurement procedures. Wiley Press, Section 11.5.2, 393–400.Google Scholar
  4. Benedetto, G., Dalmasso, F., Guarene, M. M., Righini, G. andSpagnolo, R. (1983) A method for the acoustical analysis of respiratory crackles in cryptogenic fibrosing alveolitis.IEEE Trans.,BME-30, 620–623.Google Scholar
  5. Charbonneau, G., Racineux, J. L., Sudraud, M. andTuchais, E. (1982) Digital processing techniques of breath sounds for objective assistance of asthma diagnosis.,BME-29, 736–738.Google Scholar
  6. Charbonneau, G., Racineux, J. L., Sudraud, M. andTuchais, E. (1983) An accurate recording system and its use in breath sound spectral analysis.J. Appl. Physiol.,55, 1120–1127.Google Scholar
  7. Chien, Y. T. andFu, K. S. (1968) Selection and ordering of feature observation in pattern recognition.Systems. Inf. Control,12, 394–414.MATHGoogle Scholar
  8. Chowdhury, S. K. andMajumder, A. K. (1981) Digital spectrum analysis of respiratory sounds.IEEE Trans.,BME-28, 784–788.Google Scholar
  9. Chowdhury, S. K. andMajumder, A. K. (1982) Frequency analysis of adventitious lung sounds.J. Biomed. Eng.,4, 305–312.Google Scholar
  10. Cohen, A. andLandsberg, D. (1984) Analysis and automatic classification of breath sounds.IEEE Trans.,BME-31, 585–590.Google Scholar
  11. Cugell, D. W. (1985) Lung sounds—classification and controversies.Seminars in Respirat. Med.,6, (3), 180–182.Google Scholar
  12. Dalmasso, F., Guarene, M., Spagnolo, R., Benedetto, G. andRighini, G. (1984) A computer system for timing acoustical analysis of crackles: a study in cryptogenic fibrosing alveolitis.Bull. Eur. Physiopathol. Resp.,20, 139–144.Google Scholar
  13. Druzgalski, C. K., Donnerberg, R. L. andCampbell, R. M. (1980) Techniques of recording respiratory sounds.J. Clin. Eng.,5, 321–330.Google Scholar
  14. Druzgalski, C. K. (1981) Breath sounds in pulmonary diagnosis. Proc. IEEE Frontiers Eng. Health Care, 383–385.Google Scholar
  15. Fenton, R. T., Pasterkamp, H., Tal, A. andChernick, V. (1985) Automated spectral characterization of wheezing in asthmatic children.IEEE Trans.,BME-32, 50–55.Google Scholar
  16. Forgacs, P. (1978)Lung sounds. Brailliere Tindall, London.Google Scholar
  17. Gavriely, N., Palti, Y. andAlroy, G. (1981) Spectral characteristics of normal breath sounds.J. Appl. Physiol.,50, 307–314.Google Scholar
  18. Gavriely, N., Palti, Y., Alroy, G. andGrotberg, J. G. (1984) Measurement and theory of wheezing breath sounds.J. Appl. Physiol. Respirat. Environ. Exercise Physiol.,57(2), 481–492.Google Scholar
  19. Hallgren, R. C., Huang, S. M., McMahon, S. M. andShotkey, T. P. (1982) Breath sounds: development of a sytem for measurement and analysis.J. Clin. Eng.,7, 135–141.Google Scholar
  20. Heemels, J. P., Ros, H. H., Sipkema, P. andde Vries, F. (1986) Tracheal sound detector.Med. & Biol. Eng. & Comput.,24, 182–185.CrossRefGoogle Scholar
  21. Homma, Y., Matsuzaki, M., Ogasawara, H. andMunakata, M. (1985) Phonopneumograph possible for real time tracing.Comput. & Biomed. Res.,18, 502–509.CrossRefGoogle Scholar
  22. Kanga, J. F. andKraman, S. S. (1986) Comparison of the lung sound frequency spectra of infants and adults.Pediatric Pulmonol.,2, 292–295.Google Scholar
  23. Kraman, S. S. (1980) Determination of the site of production of respiratory sounds by subtraction phonopneumography.Am. Rev. Respirat. Dis.,122, 303–309.Google Scholar
  24. Kraman, S. S. (1981) Does laryngeal noise contribute to the vesticular lung sound?,124, 292–294.Google Scholar
  25. Kraman, S. S. (1983a) Lung sounds: relative site of origin and comparative amplitudes in normal subjects.Lung,161, 57–64.Google Scholar
  26. Kraman, S. S. (1983b) The forced expiratory wheeze: its site of origin and possible association with lung compliance.Respirat.,44, 189–196.Google Scholar
  27. Krumpe, P. E., Hadley, J. andMarcum, R. A. (1984) Evaluation of bronchial air leaks by auscultation and phonopneumography.Chest,85, 777–781.Google Scholar
  28. Krumpe, P. E. (1985) Practical applications of lung sound research.Seminars in Respirat. Med.,6, (3), 229–238.Google Scholar
  29. Lessard, C. S. andWong, W. C. (1986) Correlation of constant flow rate with frequency spectrum of respiratory sounds when measured at the trachea.IEEE Trans.,BME-33, 461–463.Google Scholar
  30. Lessard, C. S. andJones, M. (1988) Effects of heart valve sounds on the frequency spectrum of respiratory sounds.Innov. Technol. Biol. Med.,9, (1), 117–123.Google Scholar
  31. Louden, R. G. (1982) Auscultation of the lung.Clin. Notes on Respirat. Dis., Autumn, 3–7.Google Scholar
  32. Majumder, A. K. andChowdhury, S. K. (1981) Recording and preliminary analysis of respiratory sounds from tuberculosis patients.Med. & Biol. Eng. & Comput.,19, 561–564.CrossRefGoogle Scholar
  33. Murphy, R. L. Jr.,Gaensler, E. A., Holford, S. K., Delbono, E. A. andEpler, G. (1984) Crackles in the early detection of asbestosis.Am. Rev. Respirat. Dis.,129, 375–379.Google Scholar
  34. Mussell, M. J., Nakazono, Y. andMiyamoto, Y. (1990a) Effect of air flow and flow transducer on tracheal breath sounds.Med. & Biol. Eng. & Comput.,28, 550–554.CrossRefGoogle Scholar
  35. Mussell, M. J., Nakazono, Y., Miyamoto, Y., Okabe, S. andTakishima, T. (1990b) Distinguishing normal and abnormal tracheal breathing sounds by principal component analysis.Jpn. J. Physiol.,40, 713–721.CrossRefGoogle Scholar
  36. Mussell, M. J. andMiyamoto, Y. (1992) Comparison of normal respiratory sounds recorded from the chest and trachea at various respiratory air flow levels.Frontiers of Med. & Biol. Eng., (in press).Google Scholar
  37. Olson, D. E. andHammersley, J. R. (1985) Mechanisms of lung sound generation.Seminars in Respirat. Med.,6 (3), 171–179.Google Scholar
  38. Peirick, J. andShepard J. W. Jr. (1983) Automated apnoea detection by computer: analysis of tracheal breath sounds.Med. & Biol. Eng. & Comput.,21, 632–635.CrossRefGoogle Scholar
  39. Ploysongsang, Y. (1983) The lung sound phase angle test for detection of small airway disease.Respirat. Physiol.,53, 203–214.CrossRefGoogle Scholar
  40. Ploysongsang, Y. (1983) The lung sound phase angle test for detection of small airway disease.Respirat. Physiol.,53, 203–214.CrossRefGoogle Scholar
  41. Rabiner, L. R. andRader, C. M. (1972)Digital signal processing. IEEE Press, New York.Google Scholar
  42. Schreiber, J. R., Anderson, W. F., Wegmann, M. J. andWaring, W. W. (1981) Frequency analysis of breath sounds by phonopneumography.Med. Instrum.,15, 331–335.Google Scholar
  43. Shim, C. S. andWilliams, H. (1983) Relationship of wheezing to the severity of obstruction in asthma.Arch. Intern. Med.,143, 890–892.CrossRefGoogle Scholar
  44. Urquhart, R. B., McGhee, J., Macleod, J. E. S., Banham, S. W. andMoran, F. (1981) The diagnostic value of pulmonary sounds: a preliminary study by computer-aided analysis.Comput. Biol. Med.,2, 129–139.CrossRefGoogle Scholar
  45. Waring, W. W., Beckerman, R. C. andHopkins, R. L. (1985) Continuous adventitious lung sounds—site and method of production and significance.Seminars in Respirat. Med.,63, (3), 201–209.CrossRefGoogle Scholar
  46. Workum, P., Holford, S. K., Delbono, E. A. andMurphy, R. L. (1982) The prevalence and character of crackles (rales) in young women without significant lung disease.Am. Rev. Respirat. Dis.,126, 921–923.Google Scholar

Copyright information

© IFMBE 1992

Authors and Affiliations

  • M. J. Mussell
    • 1
  1. 1.Laboratory of Biological Cybernetics, Department of Electrical & Information Engineering, Faculty of EngineeringYamagata UniversityYonezawaJapan

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