
Voice changes measured with a mobile phone can detect an oncoming potentially-deadly asthma attack up to three days in advance, according to new research.
Scientists from Maastricht University in the Netherlands say their high tech app can also provide a vital early warning for symptoms of chronic obstructive pulmonary disease (COPD).
A flare-up of asthma or COPD, known as an exacerbation, is when symptoms like difficulty breathing, coughing, and phlegm become suddenly worse—and sometimes, without prompt medical care, they can become dangerous.
It may soon be possible to use a daily voice-check to monitor for the earliest sign of a flare-up simply by speaking into your phone.
Study leader Dr. Sami Simons explained these sudden exacerbations are not only frightening, they can lead to longer-term deterioration and increase the risk of dying.
“Early on in my career I was told that the voice is different while a flare-up is happening.
“Now, the rise of artificial intelligence means it’s possible to perform sophisticated analysis to find patterns in audio recordings.
“Capturing voice via a mobile phone is the next logical step to detect deteriorations in asthma or COPD at home and on time.”
The study included 38 people with COPD and 35 people with asthma, who were being treated in the Netherlands.
Over the course of 12 weeks, participants were asked to use a specially designed app to record and analyze their voice daily.
Each person would record themselves speaking a long “a” sound, then either reading out a short piece of text or answering a question. They were also asked to complete a daily questionnaire to indicate whether their symptoms were flaring up.

Comparing the voice sounds with the data on symptom flare ups, researchers found that, at the very beginning of a flare up, people’s voices deteriorated in terms of tone, or pitch, the number of pauses, and voice quality.
The findings, published in the journal ERJ Open Research, showed that the measures improved as the flare-ups subsided.
“We found that the voice significantly changes—and this occurs as early as the first day that symptoms deteriorate,” said Dr. Simons, a consultant respiratory physician at Maastricht University Medical Centre.
“As the airways constrict during an exacerbation, the air that passes the vocal folds is limited.
“This weakens the normal vibration of the vocal folds, making it harder to keep the voice steady. As a result, the voice of someone with an exacerbation sounds ‘breathier’ and ‘rough.'”
The app called TACTICAS (Telemonitoring for Asthma and COPD Through voICe AnalysiS) was co-designed with patients and a start-up called Zana Technologies.
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It’s currently only available for research purposes, but Dr. Simons and his team have created a website (www.speaktoCOPD.com) to explain how the voice technology works and how people can contribute to the research with their own voices.
The research team developed machine learning algorithms that can detect exacerbations based on voice changes as early as three days before symptoms—and they’re are now testing the technology in two new studies: one in the Netherlands and one in Brazil.
The breakthrough was welcomed by the European Respiratory Society’s Dr. Marc Miravitlles.
“Being able to spot a flare up, or even anticipate it by a few days, could be really valuable in terms of reducing symptoms such as breathlessness or coughing as well as lowering the risk of lung damage, hospital admission or death.”
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“This technology could allow better monitoring and care for patients with asthma or COPD via a mobile phone wherever they are in the world,” added Dr Miravitlles, of Vall d’Hebron University Hospital in Barcelona, Spain.
“This is a good example of how new technologies and AI could really improve the quality of life of our patients with chronic respiratory diseases.”
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