# Robust COVID-19 Detection from Cough Sounds using Deep Neural Decision Tree and Forest: A Comprehensive Cross-Datasets Evaluation

arXiv: https://arxiv.org/abs/2501.01117 · HTML: https://mlsanity.com/paper/2501.01117/

## Key facts

- Cited by 4 papers in the map (data through 14 Oct 2026).
- Builds on 24 of its 125 references that are in the map.
- First posted on arXiv 2 Jan 2025.

## Builds on (most cited first, 24 of 24)

- [Imbalanced-learn: A Python Toolbox to Tackle the Curse of Imbalanced Datasets in Machine Learning](https://mlsanity.com/paper/1609.06570/) (2016)
- [Exploring Automatic Diagnosis of COVID-19 from Crowdsourced Respiratory Sound Data](https://mlsanity.com/paper/2006.05919/) (2020)
- [The COUGHVID crowdsourcing dataset: A corpus for the study of large-scale cough analysis algorithms](https://mlsanity.com/paper/2009.11644/) (2020)
- [Coswara -- A Database of Breathing, Cough, and Voice Sounds for COVID-19 Diagnosis](https://mlsanity.com/paper/2005.10548/) (2020)
- [AI4COVID-19: AI Enabled Preliminary Diagnosis for COVID-19 from Cough Samples via an App](https://mlsanity.com/paper/2004.01275/) (2020)
- [COVID-19 Cough Classification using Machine Learning and Global Smartphone Recordings](https://mlsanity.com/paper/2012.01926/) (2020)
- [The INTERSPEECH 2021 Computational Paralinguistics Challenge: COVID-19 Cough, COVID-19 Speech, Escalation & Primates](https://mlsanity.com/paper/2102.13468/) (2021)
- [Cough Against COVID: Evidence of COVID-19 Signature in Cough Sounds](https://mlsanity.com/paper/2009.08790/) (2020)
- [DiCOVA Challenge: Dataset, task, and baseline system for COVID-19 diagnosis using acoustics](https://mlsanity.com/paper/2103.09148/) (2021)
- [Exploring Self-Supervised Representation Ensembles for COVID-19 Cough Classification](https://mlsanity.com/paper/2105.07566/) (2021)
- [Virufy: Global Applicability of Crowdsourced and Clinical Datasets for AI Detection of COVID-19 from Cough](https://mlsanity.com/paper/2011.13320/) (2020)
- [Pay Attention to the cough: Early Diagnosis of COVID-19 using Interpretable Symptoms Embeddings with Cough Sound Signal Processing](https://mlsanity.com/paper/2010.02417/) (2020)
- [A Generic Deep Learning Based Cough Analysis System from Clinically Validated Samples for Point-of-Need Covid-19 Test and Severity Levels](https://mlsanity.com/paper/2111.05895/) (2021)
- [COVID-19 Detection in Cough, Breath and Speech using Deep Transfer Learning and Bottleneck Features](https://mlsanity.com/paper/2104.02477/) (2021)
- [IATos: AI-powered pre-screening tool for COVID-19 from cough audio samples](https://mlsanity.com/paper/2104.13247/) (2021)
- [Virufy: A Multi-Branch Deep Learning Network for Automated Detection of COVID-19](https://mlsanity.com/paper/2103.01806/) (2021)
- [A Semi-Supervised Algorithm for Improving the Consistency of Crowdsourced Datasets: The COVID-19 Case Study on Respiratory Disorder Classification](https://mlsanity.com/paper/2209.04360/) (2022)
- [Evaluating the COVID-19 Identification ResNet (CIdeR) on the INTERSPEECH COVID-19 from Audio Challenges](https://mlsanity.com/paper/2107.14549/) (2021)
- [A literature review on COVID-19 disease diagnosis from respiratory sound data](https://mlsanity.com/paper/2112.07670/) (2021)
- [Towards using Cough for Respiratory Disease Diagnosis by leveraging Artificial Intelligence: A Survey](https://mlsanity.com/paper/2309.14383/) (2023)
- [Diagnosis of COVID-19 and Non-COVID-19 Patients by Classifying Only a Single Cough Sound](https://mlsanity.com/paper/2102.04880/) (2021)
- [Using Deep Learning with Large Aggregated Datasets for COVID-19 Classification from Cough](https://mlsanity.com/paper/2201.01669/) (2022)
- [QUCoughScope: An Artificially Intelligent Mobile Application to Detect Asymptomatic COVID-19 Patients using Cough and Breathing Sounds](https://mlsanity.com/paper/2103.12063/) (2021)
- [UFRC: A Unified Framework for Reliable COVID-19 Detection on Crowdsourced Cough Audio](https://mlsanity.com/paper/2204.07763/) (2022)

## Built on by (most cited first, 4 of 4)

- [BenSParX: A Robust Explainable Machine Learning Framework for Parkinson's Disease Detection from Bengali Conversational Speech](https://mlsanity.com/paper/2505.12192/) (2025)
- [XAI-Driven Spectral Analysis of Cough Sounds for Respiratory Disease Characterization](https://mlsanity.com/paper/2508.14949/) (2025)
- [A XAI-based Framework for Frequency Subband Characterization of Cough Spectrograms in Chronic Respiratory Disease](https://mlsanity.com/paper/2508.16237/) (2025)
- [Fine-tuning Pre-trained Audio Models for COVID-19 Detection: A Technical Report](https://mlsanity.com/paper/2511.14939/) (2025)

## Abstract (arXiv)

This research presents a robust approach to classifying COVID-19 cough sounds using cutting-edge machine-learning techniques. Leveraging deep neural decision trees and deep neural decision forests, our methodology demonstrates consistent performance across diverse cough sound datasets. We begin with a comprehensive extraction of features to capture a wide range of audio features from individuals, whether COVID-19 positive or negative. To determine the most important features, we use recursive feature elimination along with cross-validation. Bayesian optimization fine-tunes hyper-parameters of deep neural decision tree and deep neural decision forest models. Additionally, we integrate the SMOTE during training to ensure a balanced representation of positive and negative data. Model performance refinement is achieved through threshold optimization, maximizing the ROC-AUC score. Our approach undergoes a comprehensive evaluation in five datasets: Cambridge, Coswara, COUGHVID, Virufy, and the combined Virufy with the NoCoCoDa dataset. Consistently outperforming state-of-the-art methods, our proposed approach yields notable AUC scores of 0.97, 0.98, 0.92, 0.93, 0.99, and 0.99 across the respective datasets. Merging all datasets into a combined dataset, our method, using a deep neural decision forest classifier, achieves an AUC of 0.97. Also, our study includes a comprehensive cross-datasets analysis, revealing demographic and geographic differences in the cough sounds associated with COVID-19. These differences highlight the challenges in transferring learned features across diverse datasets and underscore the potential benefits of dataset integration, improving generalizability and enhancing COVID-19 detection from audio signals.