Publication date: Sep 23, 2025
Asthma exacerbations remain a major challenge in asthma management, often due to delayed recognition and limitations of conventional monitoring tools such as peak flow meters and symptom questionnaires. These tools are typically effort dependent or retrospective, making them less suited for continuous, real-time monitoring. A novel, smartphone-based respiratory-responsive vocal biomarker (RRVB) may offer an accessible and noninvasive approach for dynamic assessment of respiratory health. This RRVB has previously demonstrated generalizable performance in cross-sectional cohorts across multiple respiratory conditions, including asthma, chronic obstructive pulmonary disease, and COVID-19, in populations spanning India and the United States. This study extended this work by evaluating the real-world, longitudinal performance of the same RRVB tool for daily asthma exacerbation monitoring via smartphones in home settings. This study aimed to evaluate the efficacy of the RRVB as a convenient real-time tool for monitoring asthma exacerbations and respiratory states in a real-world, longitudinal setting. In this prospective cohort study, 84 adult patients with asthma were enrolled from an academic medical center and followed for 90 days. Participants submitted daily 6-second voice samples and conducted peak expiratory flow measurements and surveys, including symptom reports and asthma control assessments. RRVB scores were generated in real time on the app. Asthma states (normal function, mild event, and exacerbation) were defined based on both peak expiratory flow and self-reported well-being. Risk ratios were calculated to assess the predictive validity of RRVB scores for identifying exacerbation events. Engagement was measured via frequency of completed sessions, and participant experience was evaluated through exit surveys. RRVB scores significantly stratified asthma states. The risk of experiencing an exacerbation was 2. 15 times higher (95% CI 1. 62-2. 85; P
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Semantics
| Type | Source | Name |
|---|---|---|
| disease | MESH | Asthma |
| pathway | KEGG | Asthma |
| disease | IDO | symptom |
| disease | MESH | chronic obstructive pulmonary disease |
| disease | MESH | COVID-19 |
| drug | DRUGBANK | Methylphenidate |
| drug | DRUGBANK | Elm |
| drug | DRUGBANK | Coenzyme M |