Time-Frequency Respiratory Impedance Maps Enable Within-Breath Deep Learning for Small Airway Dysfunction Identification.

Small airway dysfunction (SAD) is an early functional abnormality associated with multiple chronic airway diseases. However, clinical assessment often relies on spirometry-based indices, which require forced maneuvers and are sensitive to subject effort, thereby increasing patient burden and complicating quality control. In contrast, Impulse Oscillometry (IOS) requires only tidal breathing, imposing minimal subject burden while providing respiratory impedance indices informative for SAD identification. This study proposes a dual-domain complementary deep learning framework based on IOS for SAD identification, leveraging within-breath impedance dynamics. Specifically, raw IOS time-series signals are transformed into time-frequency respiratory impedance maps (TFRIM) capturing impedance over frequency and within-breath time. A two-stream architecture is then used to jointly learn complementary features from TFRIM and the original time-series signals. To mitigate inter-subject baseline variability, we further introduce a demographics-driven adaptive feature modulation module for subject-specific calibration. The model jointly predicts multiple small-airway indices, with decision-level fusion applied during inference. Experimental validation on 2510 subjects using five-fold cross-validation demonstrates that the proposed framework achieves an accuracy of 81.39%, outperforming representative baselines. These results suggest the potential utility of combining within-breath IOS dynamics with subject-specific calibration for SAD identification, warranting further external validation before screening deployment.