Contrasting Deep Learning Models for Direct Respiratory Insufficiency Detection Versus Blood Oxygen Saturation Estimation

Abstract: We contrast high effectiveness of state of the art deep learning architectures designed for general audio classification tasks, refined for respiratory insufficiency (RI) detection and blood oxygen saturation (SpO$_2$) estimation and classification through automated audio analysis. Recently, multiple deep learning architectures have been proposed to detect RI in COVID patients through audio analysis, achieving accuracy above 95% and F1-score above 0.93. RI is a condition associated with low SpO$_2$ levels, commonly defined as the threshold SpO$_2$ <92%. While SpO$_2$ serves as a crucial determinant of RI, a medical doctor's diagnosis typically relies on multiple factors. These include respiratory frequency, heart rate, SpO$_2$ levels, among others. Here we study pretrained audio neural networks (CNN6, CNN10 and CNN14) and the Masked Autoencoder (Audio-MAE) for RI detection, where these models achieve near perfect accuracy, surpassing previous results. Yet, for the regression task of estimating SpO$_2$ levels, the models achieve root mean square error values exceeding the accepted clinical range of 3.5% for finger oximeters. Additionally, Pearson correlation coefficients fail to surpass 0.3. As deep learning models perform better in classification than regression, we transform SpO$_2$-regression into a SpO$_2$-threshold binary classification problem, with a threshold of 92%. However, this task still yields an F1-score below 0.65. Thus, audio analysis offers valuable insights into a patient's RI status, but does not provide accurate information about actual SpO$_2$ levels, indicating a separation of domains in which voice and speech biomarkers may and may not be useful in medical diagnostics under current technologies.