Can Passive Cough Monitoring Predict COPD Exacerbations?

Morice, A. H.; den Brinker, A. C.; Crooks, M.; Thackray-Nocera, S.; Ouweltjes, O.; Rietman, R.

Abstract

Purpose: Validation of an alert mechanism for COPD exacerbations based on coughing detected by a stationary unobtrusive nighttime monitor. Methods: This prospective double-blind longitudinal study of cough monitoring included 40 chronic obstructive pulmonary disease (COPD) patients. Participants underwent cough monitoring and completed a daily questionnaire for 12 weeks. If no exacerbation occurred within that period patients were asked to continue being monitored for a further 12 weeks. The automated system identified deteriorating trends in cough based on a personalized cough classifier and the alerts were compared with patient reported exacerbation onsets. Results: Thirty-eight patients [median age 72 (range 57–84)], median FEV-1% predicted 43% (range 20–106%) completed the study and had 41 exacerbations over a total of 3981 days. For 32 patients, the cough monitor data allowed classifier personalization, trend analysis, and alert generation. Based on the trend data, it is estimated that ∼30% of exacerbations are not associated with an increase in cough. The alert mechanism flagged 59% of the exacerbations. For the cases with alerts preceding the onset, the associated lead time was 4 days or more. Conclusion: Though based on a single variable only, the cough-based alert system captured more than half of the exacerbations in a passive, free-living scenario. No adherence issues were reported, and patients confirmed the unobtrusive and hassle-free nature of the approach.

Citation

Morice, A. H., den Brinker, A. C., Crooks, M., Thackray-Nocera, S., Ouweltjes, O., & Rietman, R. (2025). Can Passive Cough Monitoring Predict COPD Exacerbations?. COPD: Journal of Chronic Obstructive Pulmonary Disease, 22(1), Article 2487909. https://doi.org/10.1080/15412555.2025.2487909

• Journal Article Type: Article
• Acceptance Date: Mar 28, 2025
• Online Publication Date: Apr 14, 2025
• Publication Date: Jan 1, 2025
• Deposit Date: Apr 26, 2025
• Publicly Available Date: Apr 28, 2025
• Journal: COPD: Journal of Chronic Obstructive Pulmonary Disease
• Print ISSN: 1541-2555
• Electronic ISSN: 1541-2563
• Publisher: Taylor and Francis
• Peer Reviewed: Peer Reviewed
• Volume: 22
• Issue: 1
• Article Number: 2487909
• DOI: https://doi.org/10.1080/15412555.2025.2487909
• Keywords: COPD; Exacerbation; Alert system; Automated cough count; Telehealth
• Public URL: https://hull-repository.worktribe.com/output/5133465