“Until now, we have not had a reliable tool for measuring peoples’ asthma symptoms overnight, so we know very little about night-time coughing and what it means,” said Dr Frank Rassouli (Cantonal Hospital St. Gallen, Switzerland). Smartphones have great potential to monitor different symptoms and detect changes early. Thus, Dr Rassouli worked with research partners from the University of St. Gallen and ETH Zurich to develop an app to measure cough.
The study included 79 adult asthma patients who were being treated at 2 clinics in Switzerland: the Lung Centre at Cantonal Hospital St Gallen and the mediX Group Practice, Zürich. Each patient visited their asthma clinic at the beginning and at the end of the study and was assessed for their use of asthma treatments, symptoms, and the impact of asthma on their daily life. All patients documented their sleep quality and nocturnal cough frequencies daily in the Pittsburgh Sleep Quality Index. In addition, sensor data of smartphones were collected in situ for 29 days. During this period, patients slept while the app audio recorded night-time coughing. The app also prompted patients to report their night-time symptoms.
Asthma was controlled in 192 weeks and uncontrolled in 116 weeks. Clinically significant deterioration occurred in 29 weeks in 25 patients. Mixed regression analyses showed that nocturnal cough and sleep quality were statistically significantly associated with asthma control on both a between- and within-patient level (P<0.05). Decision trees indicated that sleep quality was more useful for the detection of weeks with uncontrolled asthma, while nocturnal cough better detected weeks with asthma control deterioration.
Dr Rassouli said: “Our results suggest that night-time coughing can be measured fairly simply with a smartphone app and that an increase in coughing at night is an indicator that asthma is deteriorating. Monitoring asthma is really important because if we can spot early signs that it is getting worse, we can adjust medication to prevent asthma attacks.” Cut-offs using both markers predicted asthma attacks up to 5 days ahead with balanced accuracy between 70% and 75% (sensitivities 75-88% and specificities 57%-72%).
As the smartphone app was successfully used to monitor coughing in people with asthma, Dr Rassouli and his team plan to try the same technology with people who have chronic obstructive pulmonary disease.
- Rassouli F, et al. Smartphone-based cough detection predicts asthma control – description of a novel, scalable digital biomarker. Abstract 4569. ERS International Virtual Congress 2020, 7-9 Sept.
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Table of Contents: ERS 2020
Featured articles
COVID-19 and the Lung
COVID-19 infections: Bronchoscopy provides additional diagnostic certainty
COVID-19 vaccines: An ongoing race
COVID-19: What is the risk of reinfection?
COVID-19 App: The Dutch experience
Secondary pulmonary fibrosis: a possible long-term effect of severe COVID-19
COVID-19 survivors benefit from structured follow-up
Early pulmonary rehabilitation post-COVID-19 aids recovery
Asthma – What's New
Mild asthma: A fundamental change in management
Dupilumab shows long-term efficacy in asthma patients
Severe asthma: Oral corticosteroids maintenance therapy associated with toxicity
First-in-class tyrosine kinase inhibitor shows promise in severe asthma
Predicting individual effectiveness of biologics in severe asthma
IL-5 antagonist showed efficacy in chronic rhinosinusitis with nasal polyps
Treatment according to genotype: The future of asthma therapy?
COPD – The Beat Goes On
The role of chronic symptoms as early biomarkers of COPD development
Urgent call for studies in COPD patients aged 40-60 years
Nasal high-flow therapy: a novel treatment option for hypercapnic COPD patients
Exacerbation history is a reliable predictor of future exacerbations
Singing training effective as physical rehabilitation in COPD
Current prediction tools underestimate exacerbation risk of severe COPD patients
Exercise and Sleep: From Impaired Function to New Therapeutic Strategies
CPAP withdrawal has negative consequences for sleep apnoea patients
Physical activity improves AHI in sleep apnoea patients
The Tobacco Epidemic: From Vaping to Cannabis
Poly-use of nicotine products and cannabis: a deadly combination
E-cigarettes: A source of chronic lung inflammation
Social smoking: Do not underestimate the risks
Chronic Cough – State of the Art
LEAD study shows multiple phenotypes in many chronic cough patients
First-in-class P2X3 receptor antagonist shows promise for chronic cough treatment
Lung Cancer Detection
Lung cancer screening: Most patients not eligible 1-2 years prior to diagnosis
Distinct changes in lung microbiome precede clinical diagnosis of lung cancer
Best of Posters
Smartphone-based cough detection helpful in predicting asthma deterioration
Reduced lung function associated with cognitive decline in the elderly
Longer hospital stay and fewer transplants for frail ILD patients
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