Evaluating the performance of an automated respiratory rate counter in detecting fast breathing pneumonia in children using a reference video expert panel

作者：Ahad Mahmud Khan, Md Shafiqul Islam, Nabidul Haque Chowdhury, Salahuddin Ahmed, Rezwana Tabassum, Sadia Afrin, Z. Amin, Kazi Sazzadul Haque, Afroza Yeasmin Rumi, Jawata Rahman, Rakib Bhuiyan, Rizouan Ur Rashid, Kamrun Nahar, Robynne Simpson, Ayaz Ahmed, Md Mozibur Rahman, Ting Shi, Abdullah H Baqui, Steve Cunningham, Eric D. McCollum, Harry Campbell · 发表于：BMC Digital Health · 年份：2025 · DOI：10.1186/s44247-025-00175-3 · 被引用次数：1 · 研究领域：Pneumonia and Respiratory Infections、Respiratory viral infections research、Antibiotic Use and Resistance

Background: According to the World Health Organization's Integrated Management of Childhood Illness (IMCI) guidelines, childhood pneumonia diagnosis relies on counting respiratory rate (RR). Counting RR by health workers is frequently inaccurate, leading to misdiagnosis and poor outcomes. Automated RR counters could potentially overcome these limitations. To address this gap, we introduced an automated RR counter and developed a reference video expert panel (VEP) to evaluate its performance. Methods: We conducted a cross-sectional study involving children aged 0-59 months with suspected pneumonia in Bangladesh. The RR of children was counted using an automated counter (ChARM) and chest movements were simultaneously videotaped. These videos were interpreted by the VEP, trained to a standard procedure. We assessed ChARM's accuracy in comparison to the RR generated by the VEP and summarised the time taken to count RR by ChARM. Results: = 175/257), with a mean difference of 1.7 bpm and limits of agreement ranging from -6.7 to 10.2 bpm. ChARM classified age-adjusted fast and normal breathing with a sensitivity of 95.8% (95% CI: 88.1-99.1) and a specificity of 93.5% (95% CI: 89.0-96.6), demonstrating high agreement (kappa = 0.86). The median time to count the RR by ChARM was 66 s (interquartile range: 61-73 s). Conclusions: ChARM counted RR accurately against a VEP reference, indicating a potential role in supporting health workers to diagnose pneumonia. However, it was unsuccessfu...