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ANALYSIS OF THE BREATHING PATTERN FOR THE DETECTION AND CLASSIFICATION OF CHRONIC DISEASES

FOR THE DETECTION AND CLASSIFICATION OF CHRONIC DISEASES Table of Contents Résumé/Abstract 2 INTRODUCTION

Table of Contents

Résumé/Abstract

2

INTRODUCTION

3

1. CONTEXT AND PROBLEM STATEMENT :

4

1.1 Context / socio-economic interest of the project

4

1.2 Problem statement

4

1.3 State of art

4

2. METHODOLOGY

6

2.1 Problem Decomposition

6

2.2 Summary of the various steps of the methodology

8

2.3 Modelling and algorithms of the different blocks

16

2.3.1 Block 1 ;

17

2.3.2 Block 2 :

17

2.3.3 Block 3 :

18

2.3.4 Block 4 :

19

2.3.5 Block 5 :

20

2.3.6 Block 6 :

21

2.3.7 Block 7 :

21

2.3.8 Block 8 :

22

2.4

Synoptic of the program

23

3. RESULTS

25

4. ANALYSIS AND DISCUSSIONS

31

5. CONCLUSIONS ET PERSPECTIVES

32

6. REFERENCES

33

ANALYSIS AND DISCUSSIONS 31 5. CONCLUSIONS ET PERSPECTIVES 32 6. REFERENCES 33 5 GTEL, 2012-2013 Page
ANALYSIS AND DISCUSSIONS 31 5. CONCLUSIONS ET PERSPECTIVES 32 6. REFERENCES 33 5 GTEL, 2012-2013 Page

ANALYSIS OF THE BREATHING PATTERN FOR THE DETECTION AND CLASSIFICATION OF CHRONIC DISEASES

FOR THE DETECTION AND CLASSIFICATION OF CHRONIC DISEASES Résumé Ce projet vise à faciliter la prise

Résumé

Ce projet vise à faciliter la prise en charge des maladies respiratoires, en mettant à la disposition des médecins et autres spécialistes de la santé un moyen rapide d‟analyser des relevés de la courbe respiratoire d‟un sujet. Il s‟agit notamment de concevoir une application qui prend en entrée la courbe de respiration (volume en fonction du temps) échantillonnée d‟un sujet, accomplit une analyse, détecte et classifie les maladies dont les empreintes se trouveraient dans ce signal. Ceci afin que le médecin en charge puisse apporter rapidement les soins nécessaires au sujet, en cas de maladie.

Abstract

The aim of this project is to improve on the diagnosis and treatment of diseases affecting the respiratory system, by providing doctors and other health personnel, with a rapid way of analyzing data of a subject‟s respiratory pattern. In fact, the objective is to design a program with a user interface, which uses as input, sampled data of a subject‟s respiratory pattern (volume-time curve) recorded under suitable conditions, analyzes the data in order to detect and classify any disease, whose signature may be present in the respiratory signal. This would enable a quick appropriate medical care to be given to the subject, in case of any illness.

enable a quick appropriate medical care to be given to the subject, in case of any
enable a quick appropriate medical care to be given to the subject, in case of any

ANALYSIS OF THE BREATHING PATTERN FOR THE DETECTION AND CLASSIFICATION OF CHRONIC DISEASES

FOR THE DETECTION AND CLASSIFICATION OF CHRONIC DISEASES INTRODUCTION Nowadays with the fast growing world

INTRODUCTION

Nowadays with the fast growing world population, efficient widespread methods of diagnosing diseases, with or without the presence of a medical doctor, are becoming very important. A wide variety of chronic diseases affect the human respiratory pattern. In this sense, it is essential to study the symptoms of these diseases and design methods for the analysis of this pattern so as to be able to detect and classify any disease influencing it. Our objective is to design a computer program capable of analyzing a subject‟s respiratory pattern and proposing a classification of the disease(s) the person may be suffering from. We shall first present the context and problem statement of this study and later the methodology applied in order to obtain the expected results.

of this study and later the methodology applied in order to obtain the expected results. 5
of this study and later the methodology applied in order to obtain the expected results. 5

ANALYSIS OF THE BREATHING PATTERN FOR THE DETECTION AND CLASSIFICATION OF CHRONIC DISEASES

FOR THE DETECTION AND CLASSIFICATION OF CHRONIC DISEASES 1. CONTEXT AND PROBLEM STATEMENT : 1.1 Context

1.

CONTEXT AND PROBLEM STATEMENT :

1.1

Context / socio-economic interest of the project

This project aims at providing a cheap and fast way of analyzing a subject‟s respiratory pattern, it requires little experience and qualification (a technician who knows how to manipulate some hardware spirometer and record some data files). The results provided by the program (which we shall design) can then be appreciated by a specialist and necessary medical attention given to the subject, based on the results.

1.2 Problem statement

Once data files have been recorded for a given subject, they need to be treated for the necessary parameters to be extracted. We shall thus design a computer program to solve the latter problem. We shall assume in this study that the data have already been collected so we shall concentrate on the analysis of the above mentioned files.

1.3 State of art

There exist several manufacturers of computer-based systems comprising both the hardware necessary for data collection and the corresponding computer software for analysis.

and the corresponding computer software for analysis. Figure 1: A PC-based spirometer (Source: healthequip.com) 5

Figure 1: A PC-based spirometer (Source: healthequip.com)

computer software for analysis. Figure 1: A PC-based spirometer (Source: healthequip.com) 5 GTEL, 2012-2013 Page 4
computer software for analysis. Figure 1: A PC-based spirometer (Source: healthequip.com) 5 GTEL, 2012-2013 Page 4

ANALYSIS OF THE BREATHING PATTERN FOR THE DETECTION AND CLASSIFICATION OF CHRONIC DISEASES

FOR THE DETECTION AND CLASSIFICATION OF CHRONIC DISEASES Figure 2 : A USB spirometer, GUI interface
FOR THE DETECTION AND CLASSIFICATION OF CHRONIC DISEASES Figure 2 : A USB spirometer, GUI interface

Figure 2 : A USB spirometer, GUI interface (by Advanced Medical Engineering)

CHRONIC DISEASES Figure 2 : A USB spirometer, GUI interface (by Advanced Medical Engineering) 5 GTEL,
CHRONIC DISEASES Figure 2 : A USB spirometer, GUI interface (by Advanced Medical Engineering) 5 GTEL,

ANALYSIS OF THE BREATHING PATTERN FOR THE DETECTION AND CLASSIFICATION OF CHRONIC DISEASES

FOR THE DETECTION AND CLASSIFICATION OF CHRONIC DISEASES 2. METHODOLOGY 2.1 Problem Decomposition Figure 3:

2.

METHODOLOGY

2.1

Problem Decomposition

DISEASES 2. METHODOLOGY 2.1 Problem Decomposition Figure 3: Architecture of the program 5 GTEL, 2012-2013

Figure 3: Architecture of the program

2. METHODOLOGY 2.1 Problem Decomposition Figure 3: Architecture of the program 5 GTEL, 2012-2013 Page 6
2. METHODOLOGY 2.1 Problem Decomposition Figure 3: Architecture of the program 5 GTEL, 2012-2013 Page 6

ANALYSIS OF THE BREATHING PATTERN FOR THE DETECTION AND CLASSIFICATION OF CHRONIC DISEASES

FOR THE DETECTION AND CLASSIFICATION OF CHRONIC DISEASES NB: - The above classification of a subject’s

NB:

- The above classification of a subject’s condition, under:

Normal;

Obstructive;

Restrictive or

Mixed,

is the most detailed possible classification that studies permit us to perform.

- The following information should be collected for each patient whose spirogram (breathing pattern data) is recorded since they are closely related to the respiratory pattern and necessary for further analysis of the results obtained:

Age

Gender: Male or Female

Height

Weight

Smoker or not a smoker?

If female subject, pregnant or not pregnant?

- In order to record the breathing pattern data of a subject, the examiner should ensure the following:

Subject should be relaxed, sit upright and exercise no effort during the examination.

The examination should be carried out with a device that records the volume of air in the subject‟s lungs with time, and stores the data in a digital format for analysis on a computer.

The subject should insert the mouthpiece while undertaking tidal breathing (ordinary breathing) at FRC (Functional Residual Capacity), and then, in one continuous sequence, make a slow inspiration to total lung capacity (TLC), followed directly by a slow expiration to residual volume (RV), followed by a full inspiration with maximal effort to TLC and then by a full expiration with maximal effort back to RV.

then by a full expiration with maximal effort back to RV. Figure 4 : The various

Figure 4 : The various characteristics of the respiratory pattern during ordinary and forced breathing conditions

characteristics of the respiratory pattern during ordinary and forced breathing conditions 5 GTEL, 2012-2013 Page 7
characteristics of the respiratory pattern during ordinary and forced breathing conditions 5 GTEL, 2012-2013 Page 7

ANALYSIS OF THE BREATHING PATTERN FOR THE DETECTION AND CLASSIFICATION OF CHRONIC DISEASES

FOR THE DETECTION AND CLASSIFICATION OF CHRONIC DISEASES 2.2 Summary of the various steps of the

2.2 Summary of the various steps of the methodology

Step 1 : Smoothening of the breathing pattern curve to eliminate noise 1) A multilevel
Step 1 : Smoothening of the breathing pattern curve to eliminate noise
1)
A multilevel 1-D wavelet analysis or Z-transform, of the input signal i(t)
is performed.
(
)
( ( ))
2)
A low-pass filter is applied to the resulting signal (the Daubechies filter
“db4”);
(
)
(
)
(
)
(
)
followed by an inverse Z-transform;
( )
[
(
)]
and then a down sampling of factor 2 (one sample out of 2 is discarded).
(
)
( ).
3)
The above step 2 is repeated four times in order to obtain a final smooth signal.

Figure 5 : Example to illustrate the smoothening algorithm

Step 2 : Detection of the maximum turning points of the curve and the minimum turning point just after each maximum

of the curve and the minimum turning point just after each maximum Consider ( ) the

Consider (

) the set of maximum turning points.

turning point just after each maximum Consider ( ) the set of maximum turning points. 5
turning point just after each maximum Consider ( ) the set of maximum turning points. 5

ANALYSIS OF THE BREATHING PATTERN FOR THE DETECTION AND CLASSIFICATION OF CHRONIC DISEASES

FOR THE DETECTION AND CLASSIFICATION OF CHRONIC DISEASES  STEP 1: Detection of the maximum turning

STEP 1: Detection of the maximum turning points

For a point (

mean and standard deviation respectively of the

)

consider a window of

points around it, denoted as

)

data points in

(

(

) Let m, s denote the

round

.

shall be chosen by the user to refine the peak selection process.

This

point is a peak or maximum turning point if :

 

( )

(

)

|

|

for some suitably chosen value of

 

[

]

since this interval gave satisfactory peaks during tests.

i.e.

[

]

 

(

)

|

(

)|

 

(

),

(the set of peaks)

STEP 2: Detection of the minimum turning point consecutive to each maximum turning point

Minimum turning points occur at troughs between two consecutive maximum turning points.

So to detect the minimum sample between two consecutive maximum turning points, we apply the “min” function to each inter-peak interval.

By so doing we obtain the set of minima

.

interval. By so doing we obtain the set of minima . Figure 6 : Illustration of

Figure 6 : Illustration of peak and trough detection. The maxima are the red points while the minima are black:

Step 3 : Classification of the maximum values detected under “ordinary” and “forced”

Step 3 : Classification of the maximum values detected under “ordinary” and “forced” 5 GTEL, 2012-2013
Step 3 : Classification of the maximum values detected under “ordinary” and “forced” 5 GTEL, 2012-2013

ANALYSIS OF THE BREATHING PATTERN FOR THE DETECTION AND CLASSIFICATION OF CHRONIC DISEASES

FOR THE DETECTION AND CLASSIFICATION OF CHRONIC DISEASES Our objective here is classify the maxima into
Our objective here is classify the maxima into two subgroups of points ( ) (

Our objective here is classify the maxima into two subgroups of points ( ) ( ): those belonging to the ordinary breathing pattern and those belonging to the forced breathing pattern (greater values due to forceful breath). It will then be possible to evaluate characteristics pertaining to the ordinary breathing pattern (respiratory rate, tidal volume, functional residual capacity) and those pertaining to the forced breathing pattern (forced vital capacity, forced expiratory volume in 1 second, peak expiratory flow).

PROCEDURE

- A maximum turning point is selected at random amongst the above determined set of maximum

turning points (

), say,

- The difference between

This point is considered to be in the subgroup (

)

and each of the other values

of the set ( ) is then calculated :

If the absolute value of the difference is less than 0.5 litre, |

|

then the points

ORDINARY” or “FORCED”.

and

belong to the same subgroup of points (

) which could be

NB: 0.5 L because the difference in volume between two points both belonging to either the ordinary or forced breathing pattern is normally negligible.

Otherwise (the absolute value of the difference is greater than 0.5 litre), the points

i.e.

and

belong to different subgroups.

belongs to (

).

- Now an arbitrary value, chosen from the set ( ) :

is chosen from the set (

)

and compared to an arbitrary value,

,

If

then the set ( ) is the set of points which belong to the ordinary breathing

) is that which contains the points of the forced breathing

pattern and the set ( pattern.

Otherwise ( ), ( ) is the set for the forced breathing pattern and ( ) the set for the ordinary breathing pattern.

Step 4 : Calculation of the respiratory rate, functional residual capacity and tidal volume

Step 4 : Calculation of the respiratory rate, functional residual capacity and tidal volume 5 GTEL,
Step 4 : Calculation of the respiratory rate, functional residual capacity and tidal volume 5 GTEL,

ANALYSIS OF THE BREATHING PATTERN FOR THE DETECTION AND CLASSIFICATION OF CHRONIC DISEASES

FOR THE DETECTION AND CLASSIFICATION OF CHRONIC DISEASES Let be the set of maximum turning points
Let be the set of maximum turning points of the ordinary breathing pattern. Volume Sample

Let

be the set of maximum turning points of the ordinary breathing pattern.

Volume

Sample n°

Time

(

)

- Determination of the tidal volume (in Liters) :

TV (Tidal Volume): The tidal volume is the volume of air that is inhaled or exhaled in a single breath/cycle.

of air that is inhaled or exhaled in a single breath/cycle. Figure 7: Each dark double-arrowed
of air that is inhaled or exhaled in a single breath/cycle. Figure 7: Each dark double-arrowed

Figure 7: Each dark double-arrowed line indicates the amplitude of the tidal volume

- Determination of the functional residual capacity(FRC) (in liters):

The FRC is the average volume of the set of minima, of the ordinary breath pattern.

volume of the set of minima, of the ordinary breath pattern. Figure 8: The dark horizontal

Figure 8: The dark horizontal line indicates the volume level of the functional residual capacity

- Determination of the respiratory rate (in breaths per minute):

(

)

( ) ( )

(

)

- Determination of the respiratory rate (in breaths per minute): ( ) ( ) 5 GTEL,
- Determination of the respiratory rate (in breaths per minute): ( ) ( ) 5 GTEL,

ANALYSIS OF THE BREATHING PATTERN FOR THE DETECTION AND CLASSIFICATION OF CHRONIC DISEASES

FOR THE DETECTION AND CLASSIFICATION OF CHRONIC DISEASES This is done by determining the average time

This is done by determining the average time interval T (minutes) between two consecutive points of the set .

( )

(

)

(

)

(

)

 

(

)

points of the set . ( ) ( ) ( ) ( )   ( )

Figure 9 : Each dark double-arrowed line arrows indicates the size of a period (time axis horizontal)

Step 5 : Plot of the Flow Volume curve

Step 5 : Plot of the Flow – Volume curve It shows various parameters that can

It shows various parameters that can be read directly by a specialist.

– Volume curve It shows various parameters that can be read directly by a specialist. 5
– Volume curve It shows various parameters that can be read directly by a specialist. 5

ANALYSIS OF THE BREATHING PATTERN FOR THE DETECTION AND CLASSIFICATION OF CHRONIC DISEASES

FOR THE DETECTION AND CLASSIFICATION OF CHRONIC DISEASES Figure 10: Significance of the Flow - Volume
Figure 10: Significance of the Flow - Volume curve (Source: Farah Madhani-Lovely, MD) The slope
Figure 10: Significance of the Flow - Volume curve (Source: Farah Madhani-Lovely, MD)
The slope at each point of a chosen forced breathing pattern cycle (between two successive minima)
is determined using the two points on the curve that surround it (the point before and the point after).
The slope at the point ( ) where [ ] is given by:
(
)
Figure 11 : Each dark double- arrowed line indicates a set of values which can be used to
construct a Flow-Volume curve

Step 6 : Calculation of the FVC (Forced Vital Capacity), FEV1 (Forced Expiratory Volume in 1 s) and PEF (Peak Expiratory Flow)

6 : Calculation of the FVC (Forced Vital Capacity), FEV1 (Forced Expiratory Volume in 1 s)
(Forced Vital Capacity), FEV1 (Forced Expiratory Volume in 1 s) and PEF (Peak Expiratory Flow) 5
(Forced Vital Capacity), FEV1 (Forced Expiratory Volume in 1 s) and PEF (Peak Expiratory Flow) 5

ANALYSIS OF THE BREATHING PATTERN FOR THE DETECTION AND CLASSIFICATION OF CHRONIC DISEASES

FOR THE DETECTION AND CLASSIFICATION OF CHRONIC DISEASES Figure 12 : Calculation of the FVC, FEV1
Figure 12 : Calculation of the FVC, FEV1 and PEF - Determination of the Forced
Figure 12 : Calculation of the FVC, FEV1 and PEF
-
Determination of the Forced Vital Capacity (FVC) (in Liters):
This is the difference between
and
- Determination of the Forced Expiratory Volume in 1 second (FEV 1 ) (in Liters):
This is the difference between
and the volume 1 second later during expiration.
(
)
- Determination of the Peak Expiratory Flow (PEF) (in Liters per minute/ Liters per second):
This is the maximal flow or speed achieved during the maximally forced expiration initiated at
full inspiration.
)
[ (
]
(
)
[
(
)]

Step 7 : Calculation of nominal values of FVC, FEV1 and PEF

Step 7 : Calculation of nominal values of FVC, FEV1 and PEF Nominal values of FVC,

Nominal values of FVC, FEV 1 and PEF are calculated as follows:

of FVC, FEV1 and PEF Nominal values of FVC, FEV 1 and PEF are calculated as
of FVC, FEV1 and PEF Nominal values of FVC, FEV 1 and PEF are calculated as

ANALYSIS OF THE BREATHING PATTERN FOR THE DETECTION AND CLASSIFICATION OF CHRONIC DISEASES

FOR THE DETECTION AND CLASSIFICATION OF CHRONIC DISEASES where: - H is the height of the

where:

- H is the height of the subject in meters.

- A is the age of the subject in years.

- Norms provide the values of the coefcients

for each parameter.

The coefcients for FVC, FEV1 and PEF, published by the European Respiratory Society are presented in the table below. According to the norms, the age range is from 25 to 70 years and the height range is from 1.55 to 1.95 meters (for men) and from 1.45 to 1.80 meters (for women).

Coefficients

FOR MEN

FVC

FEV 1

PEF

FOR WOMEN

FVC

FEV 1

PEF

Table 1 : Standard coefficients for the calculation of the nominal values of FVC, FEV1 and PEF

These parameters demonstrate a stronger dependence on the height (large absolute value of

on the age (small absolute value of

).

) than

Step 8 : Comparison of nominal values with those obtained from the subject‟s breathing pattern and classification of a subject‟s condition

nomin al values with those obtained from the subject‟s breathing pattern and classification of a subject‟s
nomin al values with those obtained from the subject‟s breathing pattern and classification of a subject‟s
obtained from the subject‟s breathing pattern and classification of a subject‟s condition 5 GTEL, 2012-2013 Page
obtained from the subject‟s breathing pattern and classification of a subject‟s condition 5 GTEL, 2012-2013 Page

ANALYSIS OF THE BREATHING PATTERN FOR THE DETECTION AND CLASSIFICATION OF CHRONIC DISEASES

FOR THE DETECTION AND CLASSIFICATION OF CHRONIC DISEASES The individual spirometry results vary depending on the

The individual spirometry results vary depending on the conditions of the ventilation mechanism. In general, the results close to 100% of the nominal values are interpreted as normal. The results that differ 20% and more from the nominal value are considered abnormal.

With

the

age

and

height

of

a

given

subject,

the

above

nominal

values

(

) are calculated.

 

The following classification of diseases (OBSTRUCTIVE, RESTRICTIVE or MIXED) is based on the comparison of the values obtained from measurements with the nominal values.

   

OBSTRUCTIVE

 

RESTRICTIVE

MIXED

 

1)

Chronic Obstructive Pulmonary Disease which includes emphysema and chronic bronchitis Asthma Bronchiectasis Cystic Fibrosis Lung Cancer Obliterative Bronchiolitis

1)

Interstitial lung disease Sarcoidosis Obesity, including obesity hypoventilation syndrome Scoliosis Muscular dystrophy or Amyotrophic Lateral Sclerosis Parenchymal lung tumors Pulmonary edema

 

2)

3)

Diseases

4)

Both an obstructive and a restrictive disease

2)

3)

5)

4)

 

5)

6)

6)

7)

FVC

     

FEV 1

     

PEF

     

(See Figure 10 on page 13, for the Flow-Volume curve shape of each group of diseases)

2.3 Modelling and algorithms of the different blocks

curve shape of each group of diseases) 2.3 Modelling and algorithms of the different blocks 5
curve shape of each group of diseases) 2.3 Modelling and algorithms of the different blocks 5

ANALYSIS OF THE BREATHING PATTERN FOR THE DETECTION AND CLASSIFICATION OF CHRONIC DISEASES

FOR THE DETECTION AND CLASSIFICATION OF CHRONIC DISEASES 2.3.1 Block 1 ; Real signals are noisy

2.3.1 Block 1 ;

AND CLASSIFICATION OF CHRONIC DISEASES 2.3.1 Block 1 ; Real signals are noisy and need to

Real signals are noisy and need to be filtered. This block filters the input data in order to smoothen its curve and facilitate the subsequent detection of the maxima and minima it contains. After the input file is read, filtering is performed in MATLAB with the following command lines:

[C,L] =

wavedec(rough,8,'db4');

smooth = appcoef(C,L,'db4',5);

where:

- “rough” is the vector containing the samples of the input (rough) signal and

- “smooth” is the vector containing the samples of the smooth signal.

NB: The filter used is a „daubechies filter‟ and the resulting smooth signal contains times less samples than the initial rough signal.

contains times less samples than the initial rough signal. Figure 13: Example showing a rough and

Figure 13: Example showing a rough and corresponding filtered signal

2.3.2 Block 2 :

signal. Figure 13: Example showing a rough and corresponding filtered signal 2.3.2 Block 2 : 5
signal. Figure 13: Example showing a rough and corresponding filtered signal 2.3.2 Block 2 : 5
signal. Figure 13: Example showing a rough and corresponding filtered signal 2.3.2 Block 2 : 5

ANALYSIS OF THE BREATHING PATTERN FOR THE DETECTION AND CLASSIFICATION OF CHRONIC DISEASES

FOR THE DETECTION AND CLASSIFICATION OF CHRONIC DISEASES The calculation of the required parameters (FVC, FEV1,

The calculation of the required parameters (FVC, FEV1, PEF, Tidal Volume, etc…) is based on information concerning the peaks and troughs of the smooth signal. These maxima and minima therefore have to be detected.

%% Peak detection MATLAB PROGRAM max_counter_i = 0; max_counter_f = 0; for ctr = k+1 : length(xx)-k local_mean(1,ctr) = mean( [smooth(ctr-k:ctr- 1),smooth(ctr+1:ctr+k)] ); local_std(1,ctr) = std( [smooth(ctr-k:ctr- 1),smooth(ctr+1:ctr+k)] ); if ((smooth(ctr) >= local_mean(1,ctr)) && (abs( smooth(ctr) - local_mean(1,ctr) ) >= 1.12* local_std(1,ctr))) % Selection criterion for maximum

smooth(ctr),ctr];

vector

end

max_counter_i = max_counter_i + 1; Maxima_i(max_counter_i, 1:3) = [xx(ctr), %% ctr is the index of this sample in the smooth

end %% On élimine les max éloignés de la moyenne for ctr = 1 : max_counter_i if ctr == ctr %abs( Maxima_i(ctr,2) - mean(Maxima_i(:,2)) ) <= 1.5*std((Maxima_i(:,2))) max_counter_f = max_counter_f + 1; Maxima_f(max_counter_f,1:3) = Maxima_i(ctr,1:3); Maxima_f_min(max_counter_f, 1:3) =

Maxima_f(max_counter_f,1:3);

end end %% Finding the minimum after each maximum for ctr1 = 1 : max_counter_f - 1 index_start = Maxima_f(ctr1,3); index_end = Maxima_f(ctr1+1,

3);

[value, pos] = min(smooth(index_start:index_end));

%% On

recherche le min entre deux max consécutifs Maxima_f_min(ctr1,4:5) = [value, xx(pos+index_start)]; % Col1 = Time values for each max, Col2 = Max values; Col3 = index of max, Col4 = value of next min; Col5 = time of next min end test = Maxima_f_min(1,2); ctr_small_max = 1; Maxima_f_small_max(1,1:5) = Maxima_f_min(1,1:5); for ctr2 = 2: max_counter_f if (abs(test - Maxima_f_min(ctr2,2)) < 0.5) ctr_small_max = ctr_small_max + 1; Maxima_f_small_max(ctr_small_max, 1:5) =

Maxima_f_min(ctr2,1:5);

end

end

2.3.3 Block 3 :

1:5) = Maxima_f_min(ctr2,1:5); end end 2.3.3 Block 3 : 5 GTEL, 2012-2013 Page 18
1:5) = Maxima_f_min(ctr2,1:5); end end 2.3.3 Block 3 : 5 GTEL, 2012-2013 Page 18
1:5) = Maxima_f_min(ctr2,1:5); end end 2.3.3 Block 3 : 5 GTEL, 2012-2013 Page 18

ANALYSIS OF THE BREATHING PATTERN FOR THE DETECTION AND CLASSIFICATION OF CHRONIC DISEASES

FOR THE DETECTION AND CLASSIFICATION OF CHRONIC DISEASES We shall process input signals which contain a

We shall process input signals which contain a waveform for ordinary breath and a waveform for forced breath. It is essential to classify the peaks and troughs as belonging to either the ordinary or forced breath phases.

%% A portion of the MATLAB code for the classification of the peaks and troughs ctr_small_max_1 = 2; Maxima_f_small_max_1(1:2,1:5) = Maxima_f_small_max(1:2, 1:5); ctr_small_max_2 = 0; ctr_small_max_3 =0; ctr_small_max_4 = 0;

for ctr3 = 3: length(Maxima_f_small_max) if ((Maxima_f_small_max(ctr3,1) - Maxima_f_small_max(ctr3- 1,1)) < 2 * (Maxima_f_small_max(2,1) - Maxima_f_small_max(1,1)) ) ctr_small_max_1 = ctr_small_max_1 + 1; Maxima_f_small_max_1(ctr_small_max_1, 1:5) =

Maxima_f_small_max(ctr3,1:5);

else

ctr_small_max_2 = ctr_small_max_2 + 1; Maxima_f_small_max_2(ctr_small_max_2,1:5) =

Maxima_f_small_max(ctr3,1:5);

ctr_small_max_2 = ctr_small_max_2 + 1; Maxima_f_small_max_2(ctr_small_max_2,1:5) =

Maxima_f_small_max(ctr3+1,1:5);

end

end

break;

2.3.4 Block 4 :

end end break ; 2.3.4 Block 4 : %% Calculation of breath rate average1 =

%% Calculation of breath rate average1 = (length(Maxima_f_small_max_1(:,1)) - 1)/(Maxima_f_small_max_1(end,1) - Maxima_f_small_max_1(1,1)); average_resp_rate1 = 60 * average1;

average2 = (length(Maxima_f_small_max_2(:,1)) - 1)/(Maxima_f_small_max_2(end,1) - Maxima_f_small_max_2(1,1)); average_resp_rate2 = 60 * average2;

average3 = (length(Maxima_f_small_max_3(:,1)) - 1)/(Maxima_f_small_max_3(end,1) - Maxima_f_small_max_3(1,1)); average_resp_rate3 = 60 * average3;

average_resp_rate = (average_resp_rate1 + average_resp_rate2 + average_resp_rate3 )/3;

set(handles.resp_rate, 'String', num2str(average_resp_rate));

)/3; set(handles.resp_rate, 'String' , num2str(average_resp_rate)); 5 GTEL, 2012-2013 Page 19
)/3; set(handles.resp_rate, 'String' , num2str(average_resp_rate)); 5 GTEL, 2012-2013 Page 19

ANALYSIS OF THE BREATHING PATTERN FOR THE DETECTION AND CLASSIFICATION OF CHRONIC DISEASES

FOR THE DETECTION AND CLASSIFICATION OF CHRONIC DISEASES %% Calculation of tidal volume tidal1 =

%% Calculation of tidal volume tidal1 = mean(Maxima_f_small_max_1(:, 2)) - mean(Maxima_f_small_max_1(1:end-1, 4)); tidal2 = mean(Maxima_f_small_max_2(:, 2)) - mean(Maxima_f_small_max_2(1:end-1, 4)); tidal3 = mean(Maxima_f_small_max_3(:, 2)) - mean(Maxima_f_small_max_3(1:end-1, 4));

 

tidal_volume = (tidal1 + tidal2 + tidal3)/3;

set(handles.tidal_volume, 'String', num2str(tidal_volume));

%% Calculation of Functional Residual Capacity frc = (mean(Maxima_f_small_max_1(1:end-1, 4)) + mean(Maxima_f_small_max_2(1:end-1, 4)) + mean(Maxima_f_small_max_3(1:end-1,

4)))/3;

 

set(handles.frc, 'String', num2str(frc));

2.3.5

Block 5 :

'String' , num2str(frc)); 2.3.5 Block 5 : A specialist, at a glance, can identify the various

A specialist, at a glance, can identify the various calculated parameters (FVC, FEV1, PEF).

%% Plot of the Flow - Volume curve %% Partie Expiration index_maxi = Maxima_f_min_big_max_1(2, 3); index_mini2 = find (xx == Maxima_f_min_big_max_1(2, 5)); %% Tableau de Volume - en 1ère colonne et Flow rate en 2ème

colonne

compteurpts2 = 0; for indexpt = index_maxi:index_mini2 compteurpts2 = compteurpts2 + 1; Vol_Flow_Tab_exp(compteurpts2, 1:2)= [smooth(indexpt) , abs((smooth(indexpt + 1) - smooth(indexpt - 1))/( 2*xx(2)-2*xx(1)))]; end %% Partie Inspiration index_mini1 = find (xx == Maxima_f_small_max_1(ctr_small_max_1, 5)); %% Tableau de Volume - en 1ère colonne et Flow rate en 2ème

colonne

compteurpts1 = 0; for indexpt = index_mini1:index_maxi compteurpts1 = compteurpts1 + 1; Vol_Flow_Tab_ins(compteurpts1, 1:2)= [smooth(indexpt) , - abs((smooth(indexpt + 1) - smooth(indexpt - 1))/( 2*xx(2)-2*xx(1)))]; end

, - abs((smooth(indexpt + 1) - smooth(indexpt - 1))/( 2*xx(2)-2*xx(1)))]; end 5 GTEL, 2012-2013 Page 20
, - abs((smooth(indexpt + 1) - smooth(indexpt - 1))/( 2*xx(2)-2*xx(1)))]; end 5 GTEL, 2012-2013 Page 20

ANALYSIS OF THE BREATHING PATTERN FOR THE DETECTION AND CLASSIFICATION OF CHRONIC DISEASES

FOR THE DETECTION AND CLASSIFICATION OF CHRONIC DISEASES 2.3.6 Block 6 : These parameters are essential

2.3.6 Block 6 :

AND CLASSIFICATION OF CHRONIC DISEASES 2.3.6 Block 6 : These parameters are essential for detecting and

These parameters are essential for detecting and classifying a subject under (NORMAL, OBSTRUCTIVE DISEASE, RESTRICTIVE DISEASE OR MIXED).

Maxima_f_min_big_max_1(1, 1:5) = Maxima_f_min (ctr_small_max_1, 1:5); % Min before

+1

, 1:5);

Maxima_f_min_big_max_1(2, 1:5) = Maxima_f_min (ctr_small_max_1 % Max itself

Maxima_f_min_big_max_2(1, 1:5) = Maxima_f_min (ctr_small_max_1

+

ctr_small_max_2+1, 1:5);

% Min before

Maxima_f_min_big_max_2(2, 1:5) = Maxima_f_min (ctr_small_max_1

+

ctr_small_max_2+2 , 1:5); % Max itself

fvc = ( Maxima_f_min_big_max_1(2, 2) - Maxima_f_min_big_max_1(2, 4)+ Maxima_f_min_big_max_2(2, 2) - Maxima_f_min_big_max_2(2, 4) )/2;

fev1_1 = Maxima_f_min_big_max_1(2, 2) - smooth(find (xx ==

max(xx(find(abs(xx - (Maxima_f_min_big_max_1(2, 1)+1)) <=

xx(1)))))));

(xx(2)-

fev1_2 = Maxima_f_min_big_max_2(2, 2) - smooth(find (xx ==

max(xx(find(abs(xx - (Maxima_f_min_big_max_2(2, 1)+1)) <=

xx(1)))))));

fev1 = (fev1_1 + fev1_2)/2;

(xx(2)-

%% Calcul du PEF pef1 = max(smooth(Maxima_f_min_big_max_1(2, 3) + 1:find (xx == Maxima_f_min_big_max_1(2, 5)) + 1) - smooth(Maxima_f_min_big_max_1(2, 3) - 1:find (xx == Maxima_f_min_big_max_1(2, 5)) -1))/(2 *(xx(2)-xx(1))); pef2 = max(smooth(Maxima_f_min_big_max_2(2, 3) + 1:find (xx == Maxima_f_min_big_max_2(2, 5)) + 1) - smooth(Maxima_f_min_big_max_2(2, 3) - 1:find (xx == Maxima_f_min_big_max_2(2, 5)) -1))/(2 *(xx(2)-xx(1))); pef = (pef1 + pef2)/2;

2.3.7 Block 7 :

Maxima_f_min_big_max_2(2, 5)) -1))/(2 *(xx(2)-xx(1))); pef = (pef1 + pef2)/2; 2.3.7 Block 7 : 5 GTEL, 2012-2013
Maxima_f_min_big_max_2(2, 5)) -1))/(2 *(xx(2)-xx(1))); pef = (pef1 + pef2)/2; 2.3.7 Block 7 : 5 GTEL, 2012-2013
Maxima_f_min_big_max_2(2, 5)) -1))/(2 *(xx(2)-xx(1))); pef = (pef1 + pef2)/2; 2.3.7 Block 7 : 5 GTEL, 2012-2013

ANALYSIS OF THE BREATHING PATTERN FOR THE DETECTION AND CLASSIFICATION OF CHRONIC DISEASES

FOR THE DETECTION AND CLASSIFICATION OF CHRONIC DISEASES These parameters are evaluated (depend on the sex,

These parameters are evaluated (depend on the sex, height and age of the subject) so as to be compared to those evaluated above.

%% FOR MEN

 
 

if get(handles.sex, 'Value') == 1

 

fvcnom =

5.76 * (height/100) - 0.026 * age - 4.34;

fev1nom =

pefnom =

4.3 * (height/100) - 0.029 * age - 2.49; 6.14 * (height/100) - 0.043 * age + 0.15;

else

%% FOR WOMEN

fvcnom =

4.43 * (height/100) - 0.026 * age - 3.28;

fev1nom = 3.95 * (height/100) - 0.025 * age - 2.6;

pefnom =

5.5 * (height/100) - 0.03

* age - 1.11;

end

2.3.8

Block 8 :

- 0.03 * age - 1.11; end 2.3.8 Block 8 : Upon classification (by comparison), corresponding
- 0.03 * age - 1.11; end 2.3.8 Block 8 : Upon classification (by comparison), corresponding

Upon classification (by comparison), corresponding messages shall be displayed on the interface.

if

NORMAL SUBJECT

(fvc >0.8*fvcnom && fev1 > 0.8*fev1nom && pef > 0.7*pefnom)

%%

set(handles.classif_noresults, 'Visible', 'off'); set(handles.classif_normal, 'Visible', 'on'); set(handles.classif_obstruct, 'Visible', 'off'); set(handles.classif_restrict, 'Visible', 'off'); set(handles.classif_mixed, 'Visible', 'off');

elseif (fvc <= 0.8*fvcnom && pef <= 0.7*pefnom) %% OBSTRUCTIVE DISEASE

set(handles.classif_noresults, 'Visible', 'off'); set(handles.classif_normal, 'Visible', 'off'); set(handles.classif_obstruct, 'Visible', 'on'); set(handles.classif_restrict, 'Visible', 'off'); set(handles.classif_mixed, 'Visible', 'off');

elseif (fvc <= 0.8*fvcnom && fev1 <= 0.8*fev1nom) %% RESTRICTIVE DISEASE

set(handles.classif_noresults, 'Visible', 'off'); set(handles.classif_normal, 'Visible', 'off'); set(handles.classif_obstruct, 'Visible', 'off'); set(handles.classif_restrict, 'Visible', 'on'); set(handles.classif_mixed, 'Visible', 'off');

elseif (fvc <= 0.8*fvcnom && fev1 <= 0.8*fev1nom && pef <=

); elseif (fvc <= 0.8*fvcnom && fev1 <= 0.8*fev1nom && pef <= 5 GTEL, 2012-2013 Page
); elseif (fvc <= 0.8*fvcnom && fev1 <= 0.8*fev1nom && pef <= 5 GTEL, 2012-2013 Page

ANALYSIS OF THE BREATHING PATTERN FOR THE DETECTION AND CLASSIFICATION OF CHRONIC DISEASES

FOR THE DETECTION AND CLASSIFICATION OF CHRONIC DISEASES 0.7*pefnom) %% MIXED set(handles.classif_noresults,

0.7*pefnom)

%% MIXED

set(handles.classif_noresults, 'Visible', 'off'); set(handles.classif_normal, 'Visible', 'off'); set(handles.classif_obstruct, 'Visible', 'off'); set(handles.classif_restrict, 'Visible', 'off'); set(handles.classif_mixed, 'Visible', 'on');

else

%% NONE

 

set(handles.classif_noresults, 'Visible', 'off'); set(handles.classif_normal, 'Visible', 'on'); set(handles.classif_obstruct, 'Visible', 'off'); set(handles.classif_restrict, 'Visible', 'off'); set(handles.classif_mixed, 'Visible', 'off');

end

2.4 Synoptic of the program

, 'off' ); end 2.4 Synoptic of the program Figure 14 : Synoptic of the program

Figure 14 : Synoptic of the program

, 'off' ); end 2.4 Synoptic of the program Figure 14 : Synoptic of the program
, 'off' ); end 2.4 Synoptic of the program Figure 14 : Synoptic of the program

ANALYSIS OF THE BREATHING PATTERN FOR THE DETECTION AND CLASSIFICATION OF CHRONIC DISEASES

ANALYSIS OF THE BREATHING PATTERN FOR THE DETECTION AND CLASSIFICATION OF CHRONIC DISEASES 5 GTEL, 2012-2013
ANALYSIS OF THE BREATHING PATTERN FOR THE DETECTION AND CLASSIFICATION OF CHRONIC DISEASES 5 GTEL, 2012-2013
ANALYSIS OF THE BREATHING PATTERN FOR THE DETECTION AND CLASSIFICATION OF CHRONIC DISEASES 5 GTEL, 2012-2013

ANALYSIS OF THE BREATHING PATTERN FOR THE DETECTION AND CLASSIFICATION OF CHRONIC DISEASES

FOR THE DETECTION AND CLASSIFICATION OF CHRONIC DISEASES 3. RESULTS The program once launched shows the

3.

RESULTS

The program once launched shows the interface below.

RESULTS The program once launched shows the interface below. Figure 15 : Presentation of the program

Figure 15 : Presentation of the program interface

To proceed we need to select an input file in one of three possible manners:

Either by clicking on the “File item of the Menu”, by clicking on the Text Box beneath “Respiratory data faile (*.mat)” or by clicking the “Browse …” button.

(*.mat)” or by clicking the “Browse …” button. Figure 16 : Loading a file in 3

Figure 16 : Loading a file in 3 different manners

Then select an input file in the dialog box.

Figure 16 : Loading a file in 3 different manners Then select an input file in
Figure 16 : Loading a file in 3 different manners Then select an input file in

ANALYSIS OF THE BREATHING PATTERN FOR THE DETECTION AND CLASSIFICATION OF CHRONIC DISEASES

FOR THE DETECTION AND CLASSIFICATION OF CHRONIC DISEASES Figure 17 : Selecting a file in the
FOR THE DETECTION AND CLASSIFICATION OF CHRONIC DISEASES Figure 17 : Selecting a file in the

Figure 17 : Selecting a file in the dialog box

After the input file is selected, its content is displayed on the interface. Both the raw input signal and the corresponding filtered signal are displayed on the interface.

filtered signal are displayed on the interface. Figure 18 : Display of the raw input signal

Figure 18 : Display of the raw input signal and filtered signal

The type of data present in the file has to be selected and the age, sex and height of the subject defined. The size of the local statistics window used in peak detection has a default value which can be modified, so as find an optimum value for the selected input signal (i.e. a value which enables an acceptable peak detection as illustrated on the interface)

(i.e. a value which enables an acceptable peak detection as illustrated on the interface) 5 GTEL,
(i.e. a value which enables an acceptable peak detection as illustrated on the interface) 5 GTEL,

ANALYSIS OF THE BREATHING PATTERN FOR THE DETECTION AND CLASSIFICATION OF CHRONIC DISEASES

FOR THE DETECTION AND CLASSIFICATION OF CHRONIC DISEASES Figure 19: Type of input data,age, sex ,height
FOR THE DETECTION AND CLASSIFICATION OF CHRONIC DISEASES Figure 19: Type of input data,age, sex ,height

Figure 19: Type of input data,age, sex ,height and local statistics window size

For instance, for

we have an acceptable peak and trough detection.

for we have an acceptable peak and trough detection. Figure 20 : Example of peak and

Figure 20 : Example of peak and trough detection for k = 3 (ordinary and forced breath)

For

the peaks and troughs detected are not satisfactory.

k = 3 (ordinary and forced breath) For the peaks and troughs detected are not satisfactory.
k = 3 (ordinary and forced breath) For the peaks and troughs detected are not satisfactory.

ANALYSIS OF THE BREATHING PATTERN FOR THE DETECTION AND CLASSIFICATION OF CHRONIC DISEASES

FOR THE DETECTION AND CLASSIFICATION OF CHRONIC DISEASES Figure 21 : Example of peak detection for
FOR THE DETECTION AND CLASSIFICATION OF CHRONIC DISEASES Figure 21 : Example of peak detection for

Figure 21 : Example of peak detection for k = 10 - Not satisfactory, since several peaks detected at a single point

For this other signal (in the ordinary breath mode),

gives the best results.

(in the ordinary breath mode), gives the best results. Figure 22 : Example of peak and

Figure 22 : Example of peak and trough detection for k = 5 (ordinary breath only)

In the ordinary breath mode, three parameters (TV, FRC and Respiratory rate) are evaluated, once the button:

FRC and Respiratory rate) are evaluated, once the button: is clicked. Figure 23 : Calculation of

is clicked.

rate) are evaluated, once the button: is clicked. Figure 23 : Calculation of respiratory rate, tidal

Figure 23 : Calculation of respiratory rate, tidal volume and functional residual capacity (in ordinary breath mode)

In the “ordinary and forced breath mode”, with an appropriate signal of course, in addition to the above three parameters, the Flow-Volume curve, nominal and derived values of FVC, FEV1 and PEF are evaluated as well as a classification of the subject‟s condition is given. In the example below, the subject is normal.

of the subject‟s condition is given. In the example below, the subject is normal. 5 GTEL,
of the subject‟s condition is given. In the example below, the subject is normal. 5 GTEL,

ANALYSIS OF THE BREATHING PATTERN FOR THE DETECTION AND CLASSIFICATION OF CHRONIC DISEASES

FOR THE DETECTION AND CLASSIFICATION OF CHRONIC DISEASES Figure 24 : Output for the analysis of
FOR THE DETECTION AND CLASSIFICATION OF CHRONIC DISEASES Figure 24 : Output for the analysis of

Figure 24 : Output for the analysis of a signal in the "ordinary and forced breath mode"

A PDF report can be generated at this point.

in the "ordinary and forced breath mode" A PDF report can be generated at this point.
in the "ordinary and forced breath mode" A PDF report can be generated at this point.
in the "ordinary and forced breath mode" A PDF report can be generated at this point.

ANALYSIS OF THE BREATHING PATTERN FOR THE DETECTION AND CLASSIFICATION OF CHRONIC DISEASES

FOR THE DETECTION AND CLASSIFICATION OF CHRONIC DISEASES Figure 25 : Generating a PDF report By
FOR THE DETECTION AND CLASSIFICATION OF CHRONIC DISEASES Figure 25 : Generating a PDF report By

Figure 25 : Generating a PDF report

By clicking the “View Report” menu item, we can view this report.

the “View Report” menu item, we can view this report. Figure 26 : Viewing the report

Figure 26 : Viewing the report

we can view this report. Figure 26 : Viewing the report Figure 27 : The "About"
we can view this report. Figure 26 : Viewing the report Figure 27 : The "About"

Figure 27 : The "About" menu item

can view this report. Figure 26 : Viewing the report Figure 27 : The "About" menu
can view this report. Figure 26 : Viewing the report Figure 27 : The "About" menu

ANALYSIS OF THE BREATHING PATTERN FOR THE DETECTION AND CLASSIFICATION OF CHRONIC DISEASES

FOR THE DETECTION AND CLASSIFICATION OF CHRONIC DISEASES 4. ANALYSIS AND DISCUSSIONS The work done in

4. ANALYSIS AND DISCUSSIONS

The work done in this project is an important part of the design of computer-based spirometers (comprising hardware and corresponding computer software for the analysis of data collected). The algorithms applied in the data processing are used worldwide and are known to be efficient. Nowadays manufacturers of computer-based spirometry systems sell their hardware accompanied by the corresponding software for data analysis, which cannot be used for just any type of hardware. They also provide the necessary connectors between the hardware and computer (usually USB communication).

This work is thus that fragment of the system, which is data processing on a computer, and requires conveniently formatted data for analysis. The data file should be accompanied by a header file containing information like the gain, the units of the samples, the sampling frequency, the duration of the record, etc… In this project, the input data was provided by a *.mat file (containing the values of the samples) accompanied by a header *.info file (containing information necessary for the interpretation of the samples). The following is an example of a header file:

Source: MATSON 5GTEL Start: [00:00:10.000] val has 1 row (signal) and 16001 columns (samples/signal) Duration: 1:04 Sampling frequency: 250 Hz Sampling interval: 0.004 sec

Row Signal Gain

Base

Units

1 RESP

1

0

Liters

To convert from raw units to the physical units shown above, subtract 'base' and divide by 'gain'.

Useful output data can be rendered by our program, provided that the input data is correctly recorded and the header file correctly filled.

provided that the input data is correctly recorded and the header file correctly filled. 5 GTEL,
provided that the input data is correctly recorded and the header file correctly filled. 5 GTEL,

ANALYSIS OF THE BREATHING PATTERN FOR THE DETECTION AND CLASSIFICATION OF CHRONIC DISEASES

FOR THE DETECTION AND CLASSIFICATION OF CHRONIC DISEASES 5. CONCLUSIONS ET PERSPECTIVES Our objective in this

5. CONCLUSIONS ET PERSPECTIVES

Our objective in this project was to provide a cheap and fast way of analyzing a subject‟s respiratory pattern, through a method requiring little experience and qualification. Our user interface had to take as input a subject‟s respiratory data file, age, height and sex. The results provided by our program can be appreciated by a specialist and necessary medical attention given to the subject, based on the results.

First and foremost, the input data was filtered, then the maxima and minima detected. The method used for detecting peaks and troughs on the respiratory curve uses a local statistics window for each sample, of size, , where can be entered by the user and modified until the peaks and troughs displayed on the curve appear to be satisfactory.

Upon classification of the obtained maxima and minima, useful parameters can then be evaluated, in order to perform the classification of a subject‟s condition under “normal”, obstructive disease”, “restrictive disease” or “both restrictive and obstructive disease”.

With our designed interface, it is possible to analyze data for “ordinary breath only” or “both ordinary and forced breath”.

The program could not be sufficiently tested due to the lack of real respiratory data files obtained from persons with different respiratory diseases or conditions.

Due to the absence of respiratory data files, a test signal was generated in MATLAB and recorded in a *.mat file, in order to test our program.

%% MATLAB CODE FOR THE GENERATION OF A TEST SIGNAL

x

= [0:13, 20, 25:45, 52, 57:64];

y

= [3, 2.5, 3, 3.5, 3, 2.5, 3, 3.5, 3, 2.5, 3, 3.5, 3, 2, 6, 2, 3, 3.5,

3,

2.5, 3, 3.5, 3, 2.5, 3, 3.5, 3, 2.5, 3, 3.5, 3, 2.5, 3, 3.5, 3, 2, 6,

2,

3, 3.5, 3, 2.5, 3, 3.5, 3];

xx

= 0:1/250:64;

val = spline(x,y,xx); plot(x,y,'o',xx,val) save('testsignal.mat', 'val', '-mat')

Further studies may enable us to refine our parameters, by testing our program with real data collected from real subjects.

In fact, programs designed for the analysis of the breathing pattern are most often hardware-specific and the conditions under which the data should be collected are clearly specified otherwise the data are said to be non-acceptable.

should be collected are clearly specified otherwise the data are said to be non-acceptable. 5 GTEL,
should be collected are clearly specified otherwise the data are said to be non-acceptable. 5 GTEL,

ANALYSIS OF THE BREATHING PATTERN FOR THE DETECTION AND CLASSIFICATION OF CHRONIC DISEASES

FOR THE DETECTION AND CLASSIFICATION OF CHRONIC DISEASES 6. REFERENCES [1] Farah Madhani-Lovely, MD

6.

REFERENCES

[1] Farah Madhani-Lovely, MD Pulmonologist/Intensivist, WhydoSpirometry.ppt, Oct. 24 th 2007;

[2] Renzetti AD Jr. Standardization of spirometry. Am Rev Respir Dis 1979; 119: 831838;

[3] American Thoracic Society. Standardization of spirometry: 1987 update. Am Rev Respir Dis 1987;

136:

[4] Ferrer M, Alonso J, Morera J, et al. Chronic obstructive pulmonary disease and health related quality of life. Ann Int Med 1997; 127: 10721079.

[5] Friedman M, Serby C, Menjoge S, Wilson J, Hilleman D, Witek T. Pharmacoeconomic evaluation of a combination of ipratropium plus albuterol compared with ipratropium alone and albuterol alone in COPD. Chest 1999; 115: 635641.

[6] P. Quanjer, J. Tammeling, J. Cotes, “Long volumes and forced ventilatory flows: report of working party, standardization of lung function tests”, Eur. Respir. Journal, vol. 6, 1993, pp. 5-

40.

[7]

P.

Quanjer,

M.

Lebowitz,

I.

Gregg,

“Peak

expiratory

flow: conclusions

and

recommendations of

a

Working

Party

of

the European

Respiratory

Society.

Official

ERS

Statement”, Eur. Respir. J., vol. 10, 1997, pp. 2-8.

Society. Official ERS Statement”, Eur. Respir. J., vol. 10, 1997, pp. 2 -8. 5 GTEL, 2012-2013
Society. Official ERS Statement”, Eur. Respir. J., vol. 10, 1997, pp. 2 -8. 5 GTEL, 2012-2013