Instantaneous frequency based index to characterize respiratory crackles.

Crackle is a lung sound widely employed by health staff to identify respiratory diseases. The two-cycle duration (2CD) is a quantitative index pointed out by the American Thoracic Society and the European Respiratory Society to classify respiratory crackles as fine or coarse. However, this index, measured in the time domain, is highly affected by noise and filters of recording systems. Such factors hamper the analysis of data reported by different research groups. This work proposes a new index based on the instantaneous frequency of crackles estimated by means of discrete-time pseudo Wigner-Ville distribution.Comparisons between 2CD and the proposed index were carried out for simulated and actual crackles. Normal breathing sounds were added to simulated crackles; the resulting signals were then applied to a band-pass filter that mimics those belonging to lung sound acquisition systems. Thus, the impact of noise and filtering on these two indices was assessed for simulated crackles. Kruskal-Wallis and Dunn's tests as well as Gaussian mixture model (GMM) were applied to the two indices measured from 382 actual crackles belonging to open databases.The proposed index is much less susceptible to waveform distortions due to noise and filtering when compared to the 2CD. Thus, the statistical analyses allow the identification of two classes of crackles from actual databases; the same does not occur when using 2CD.The new proposed index has the potential to contribute for a better characterization of crackles generated by different respiratory diseases, assisting their diagnosis during clinical exams.