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Toward Improved Ecological Validity in the Acoustic Measurement of Overall Voice Quality: Combining Continuous Speech and Sustained Vowels

  • Youri Maryn
    Correspondence
    Address correspondence and reprint requests to Youri Maryn, Department of Speech-Language Pathology and Audiology, Sint-Jan General Hospital, Ruddershove 10, 8000 Bruges, Belgium.
    Affiliations
    Department of Otorhinolaryngology, Head and Neck Surgery, Speech-Language Pathology and Audiology, Sint-Jan General Hospital, Bruges, Belgium

    Faculty of Health Care Vesalius, University College Ghent, Ghent, Belgium

    Department of Otorhinolaryngology & Head and Neck Surgery and Speech-Language Pathology, Faculty of Medicine and Health Sciences, University of Ghent, Ghent, Belgium
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  • Paul Corthals
    Affiliations
    Faculty of Health Care Vesalius, University College Ghent, Ghent, Belgium

    Department of Otorhinolaryngology & Head and Neck Surgery and Speech-Language Pathology, Faculty of Medicine and Health Sciences, University of Ghent, Ghent, Belgium
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  • Paul Van Cauwenberge
    Affiliations
    Department of Otorhinolaryngology & Head and Neck Surgery and Speech-Language Pathology, Faculty of Medicine and Health Sciences, University of Ghent, Ghent, Belgium
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  • Nelson Roy
    Affiliations
    Department of Communication Sciences and Disorders, University of Utah, Salt Lake City, Utah
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  • Marc De Bodt
    Affiliations
    Department of Otorhinolaryngology & Head and Neck Surgery and Speech-Language Pathology, Faculty of Medicine and Health Sciences, University of Ghent, Ghent, Belgium

    Department of Otorhinolaryngology & Head and Neck Surgery and Communication Disorders, University Hospital, Antwerp, Belgium
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Published:November 02, 2009DOI:https://doi.org/10.1016/j.jvoice.2008.12.014

      Summary

      To improve ecological validity, perceptual and instrumental assessment of disordered voice, including overall voice quality, should ideally sample both sustained vowels and continuous speech. This investigation assessed the utility of combining both voice contexts for the purpose of auditory-perceptual ratings as well as acoustic measurement of overall voice quality. Sustained vowel and continuous speech samples from 251 subjects with (n=229) or without (n=22) various voice disorders were concatenated and perceptually rated on overall voice quality by five experienced voice clinicians. After removing the nonvoiced segments within the continuous speech samples, the concatenated samples were analyzed using 13 acoustic measures based on fundamental frequency perturbation, amplitude perturbation, spectral and cepstral analyses. Stepwise multiple regression analysis yielded a six-variable acoustic model for the multiparametric measurement of overall voice quality of the concatenated samples (with a cepstral measure as the main contributor to the prediction of overall voice quality). The correlation of this model with mean ratings of overall voice quality resulted in rs=0.78. A cross-validation approach involving the iterated internal cross-correlations with 30 subgroups of 100, 50, and 10 samples confirmed a comparable degree of association. Furthermore, the ability of the model to distinguish voice-disordered from vocally normal participants was assessed using estimates of diagnostic precision including receiver operating characteristic (ROC) curve analysis, sensitivity, and specificity, as well as likelihood ratios (LRs), which adjust for base-rate differences between the groups. Depending on the cutoff criteria employed, the analyses revealed an impressive area under ROC=0.895 as well as respectable sensitivity, specificity, and LR. The results support the diagnostic utility of combining voice samples from both continuous speech and sustained vowels in acoustic and perceptual analysis of disordered voice. The findings are discussed in relation to the extant literature and the need for further refinement of the acoustic algorithm.

      Key Words

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