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Continuous cough monitoring using ambient sound recording during convalescence from a COPD exacerbation

Crooks, Michael G.; den Brinker, Albertus; Hayman, Yvette; Williamson, James D.; Innes, Andrew; Wright, Caroline E.; Hill, Peter; Morice, Alyn H.


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Dr Michael Crooks
Senior Clinical Lecturer in Respiratory Medicine

Albertus den Brinker

Yvette Hayman

James D. Williamson

Andrew Innes

Caroline E. Wright

Peter Hill


Purpose Cough is common in chronic obstructive pulmonary disease (COPD) and is associated with frequent exacerbations and increased mortality. Cough increases during acute exacerbations (AE-COPD), representing a possible metric of clinical deterioration. Conventional cough monitors accurately report cough counts over short time periods. We describe a novel monitoring system which we used to record cough continuously for up to 45 days during AE-COPD convalescence. Methods This is a longitudinal, observational study of cough monitoring in AE-COPD patients discharged from a single teaching-hospital. Ambient sound was recorded from two sites in the domestic environment and analysed using novel cough classifier software. For comparison, the validated hybrid HACC/LCM cough monitoring system was used on days 1, 5, 20 and 45. Patients were asked to record symptoms daily using diaries. Results Cough monitoring data were available for 16 subjects with a total of 568 monitored days. Daily cough count fell significantly from mean±SEM 272.7±54.5 on day 1 to 110.9±26.3 on day 9 (p<0.01) before plateauing. The absolute cough count detected by the continuous monitoring system was significantly lower than detected by the hybrid HACC/LCM system but normalised counts strongly correlated (r=0.88, p<0.01) demonstrating an ability to detect trends. Objective cough count and subjective cough scores modestly correlated (r=0.46). Conclusions Cough frequency declines significantly following AE-COPD and the reducing trend can be detected using continuous ambient sound recording and novel cough classifier software. Objective measurement of cough frequency has the potential to enhance our ability to monitor the clinical state in patients with COPD.


Crooks, M. G., den Brinker, A., Hayman, Y., Williamson, J. D., Innes, A., Wright, C. E., …Morice, A. H. (2017). Continuous cough monitoring using ambient sound recording during convalescence from a COPD exacerbation. Lung, 195(3), 289-294.

Journal Article Type Article
Acceptance Date Mar 9, 2017
Online Publication Date Mar 28, 2017
Publication Date Jun 1, 2017
Deposit Date Mar 16, 2017
Publicly Available Date Mar 28, 2017
Journal Lung
Print ISSN 0341-2040
Electronic ISSN 1432-1750
Publisher Springer Verlag
Peer Reviewed Peer Reviewed
Volume 195
Issue 3
Pages 289-294
Keywords Chronic Obstructive Pulmonary Disease; Cough; Disease exacerbation; Outpatient monitoring; Telemedicine
Public URL
Publisher URL
Additional Information Copy of article first published in: Lung, 2017, v.195, issue 3


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Copyright Statement
© The Author(s) 2017<br /> Open Access<br /> This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (, which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.

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