Lung-SRAD: Spectral-Aware Regularized Audio DASS with Dual-Axis Patch-Mix Contrastive Learning for Respiratory Sound Classification

Recent respiratory sound classification (RSC) studies largely rely on CLS-token driven self-attention architectures such as the Audio Spectrogram Transformer (AST). While effective at modeling global context, recent analyses suggest a low-pass filtering behavior that may reduce sensitivity to localized abnormal patterns. In this work, we investigate State Space Models (SSMs) as an alternative backbone for RSC. Using the Distilled Audio State Space model, we analyze intermediate representations through spectral response curves and observe stronger preservation of mid-to-high spatial-frequency components. Based on these observations, we introduce spectral-aware layer regularization using Gaussian convolution applied to selected layers. We further propose Dual-Axis Patch-Mix contrastive learning tailored to SSM-based audio models for robust representation learning. Experiments on the ICBHI benchmark show that our approach achieves 64.48% score, outperforming the AST baseline by 5%. Code is available at https://github.com/RSC-Toolkit/Lung-SRAD.

Quality Adaptive Angular Margin Learning for Respiratory Sound Classification

We present a quality-adaptive angular-margin learning framework that improves feature generalization by enforcing intra-class compactness and inter-class separability. Our framework, titled QLung, introduces a no-reference audio quality margin derived from spectral entropy and root-mean-square energy, which adaptively scales angular margins based on recording quality. To this end, we propose a log-scaled angular margin that stabilizes training under severe class imbalance. We also use an angular classifier that normalizes features and class weights, ensuring margin penalties are applied consistently on the unit hypersphere. Our approach improves in-distribution performance on the ICBHI dataset by 2.46\% over the cross-entropy baseline, and most significantly, achieves the strongest out-of-distribution performance on the SPRSound dataset compared to prior state-of-the-art methods. Code is available at https://github.com/RSC-Toolkit/QLung.

Mitigating Stethoscope-Induced Shortcuts in Respiratory Sound Classification under Federated Domain Generalization with Causality-Inspired Interventions

AI-driven respiratory sound classification (RSC) is promising for automated pulmonary disease detection, yet multi-site deployment is hindered by inter-stethoscope variability. We introduce a federated domain generalization (FedDG) formulation for RSC under stethoscope-induced device shifts, where clients use heterogeneous devices and the model is evaluated on unseen devices. Our empirical analysis shows that stethoscope-induced style and disease-specific content are tightly entangled, making deterministic style removal unreliable. In response, we propose a causality-inspired multimodal FedDG framework that combines: (i) a causality-inspired device style intervention network that performs content-preserving style perturbations, (ii) counterfactual text augmentation that neutralizes metadata shortcuts, and (iii) gradient alignment that facilitates device-invariant representations across clients. Built on a multimodal language-audio pretraining model, it outperforms conventional data augmentation and federated learning baselines in leave-one-device-out validation on ICBHI and SPRSound datasets. Code will be released upon publication.

Meta-Ensemble Learning with Diverse Data Splits for Improved Respiratory Sound Classification

Training reliable respiratory sound classification models remains challenging due to the limited size and subject diversity of datasets. Ensemble methods can improve robustness, but when base models are trained on identical data, models tend to overfit and produce highly correlated predictions, thereby reducing the effectiveness of ensembling. In this work, we investigate a meta-ensemble learning methodology that enhances prediction diversity by training base models on diverse data splits and combining their outputs through a trained meta-model. Specifically, we train base models on the ICBHI dataset using two data split settings: fixed 80-20% split and five-fold cross-validation split, under two data granularity settings: patient- and sample-level. The resulting diversity in base model predictions enables the meta-model to better generalize. Our approach achieves new state-of-the-art performance on the ICBHI benchmark, reaching a Score of 66.49% and showing improved generalization on two out-of-distribution datasets, indicating its potential applicability to real-world clinical data.

Improving Respiratory Sound Classification with Architecture-Agnostic Knowledge Distillation from Ensembles

Respiratory sound datasets are limited in size and quality, making high performance difficult to achieve. Ensemble models help but inevitably increase compute cost at inference time. Soft label training distills knowledge efficiently with extra cost only at training. In this study, we explore soft labels for respiratory sound classification as an architecture-agnostic approach to distill an ensemble of teacher models into a student model. We examine different variations of our approach and find that even a single teacher, identical to the student, considerably improves performance beyond its own capability, with optimal gains achieved using only a few teachers. We achieve the new state-of-the-art Score of 64.39 on ICHBI, surpassing the previous best by 0.85 and improving average Scores across architectures by more than 1.16. Our results highlight the effectiveness of knowledge distillation with soft labels for respiratory sound classification, regardless of size or architecture.

Tri-MTL: A Triple Multitask Learning Approach for Respiratory Disease Diagnosis

Auscultation remains a cornerstone of clinical practice, essential for both initial evaluation and continuous monitoring. Clinicians listen to the lung sounds and make a diagnosis by combining the patient's medical history and test results. Given this strong association, multitask learning (MTL) can offer a compelling framework to simultaneously model these relationships, integrating respiratory sound patterns with disease manifestations. While MTL has shown considerable promise in medical applications, a significant research gap remains in understanding the complex interplay between respiratory sounds, disease manifestations, and patient metadata attributes. This study investigates how integrating MTL with cutting-edge deep learning architectures can enhance both respiratory sound classification and disease diagnosis. Specifically, we extend recent findings regarding the beneficial impact of metadata on respiratory sound classification by evaluating its effectiveness within an MTL framework. Our comprehensive experiments reveal significant improvements in both lung sound classification and diagnostic performance when the stethoscope information is incorporated into the MTL architecture.

BTS: Bridging Text and Sound Modalities for Metadata-Aided Respiratory Sound Classification

Respiratory sound classification (RSC) is challenging due to varied acoustic signatures, primarily influenced by patient demographics and recording environments. To address this issue, we introduce a text-audio multimodal model that utilizes metadata of respiratory sounds, which provides useful complementary information for RSC. Specifically, we fine-tune a pretrained text-audio multimodal model using free-text descriptions derived from the sound samples' metadata which includes the gender and age of patients, type of recording devices, and recording location on the patient's body. Our method achieves state-of-the-art performance on the ICBHI dataset, surpassing the previous best result by a notable margin of 1.17%. This result validates the effectiveness of leveraging metadata and respiratory sound samples in enhancing RSC performance. Additionally, we investigate the model performance in the case where metadata is partially unavailable, which may occur in real-world clinical setting.

RepAugment: Input-Agnostic Representation-Level Augmentation for Respiratory Sound Classification

Recent advancements in AI have democratized its deployment as a healthcare assistant. While pretrained models from large-scale visual and audio datasets have demonstrably generalized to this task, surprisingly, no studies have explored pretrained speech models, which, as human-originated sounds, intuitively would share closer resemblance to lung sounds. This paper explores the efficacy of pretrained speech models for respiratory sound classification. We find that there is a characterization gap between speech and lung sound samples, and to bridge this gap, data augmentation is essential. However, the most widely used augmentation technique for audio and speech, SpecAugment, requires 2-dimensional spectrogram format and cannot be applied to models pretrained on speech waveforms. To address this, we propose RepAugment, an input-agnostic representation-level augmentation technique that outperforms SpecAugment, but is also suitable for respiratory sound classification with waveform pretrained models. Experimental results show that our approach outperforms the SpecAugment, demonstrating a substantial improvement in the accuracy of minority disease classes, reaching up to 7.14%.

Adversarial Fine-tuning using Generated Respiratory Sound to Address Class Imbalance

Deep generative models have emerged as a promising approach in the medical image domain to address data scarcity. However, their use for sequential data like respiratory sounds is less explored. In this work, we propose a straightforward approach to augment imbalanced respiratory sound data using an audio diffusion model as a conditional neural vocoder. We also demonstrate a simple yet effective adversarial fine-tuning method to align features between the synthetic and real respiratory sound samples to improve respiratory sound classification performance. Our experimental results on the ICBHI dataset demonstrate that the proposed adversarial fine-tuning is effective, while only using the conventional augmentation method shows performance degradation. Moreover, our method outperforms the baseline by 2.24% on the ICBHI Score and improves the accuracy of the minority classes up to 26.58%. For the supplementary material, we provide the code at https://github.com/kaen2891/adversarial_fine-tuning_using_generated_respiratory_sound.