Summary
Objectives
The purpose of this study was to examine the strength of relationship between impairment-level
acoustic measures derived from spectral- and cepstral-based analyses (including the
cepstral peak prominence [CPP]; ratios of low vs high frequency spectral energy; and
the respective standard deviations [SDs] for these measures) and a disablement measure
(the total Voice Handicap Index [VHI] score) in a large and diverse group of voice-disordered
and control subjects. The relationship between total VHI and the Cepstral Spectral
Index of Dysphonia (CSID—a multivariate estimate of dysphonia severity) was also examined.
Methods
Subjects were 332 adults (116 males and 216 females) comprised of voice-disordered
subjects who presented to a physician with a voice-related complaint (n = 258) and
a group of nonvoice-disordered control subjects (n = 74). A VHI 30-item score and
speech/voice samples including the second and third sentences of The Rainbow Passage
and productions of the sustained vowel /ɑ/ were obtained for each subject. Sentence
and sustained vowel samples were analyzed using the Analysis of Dysphonia in Speech and Voice (ADSV) program (ADSV model 5109 v.3.4.2; KayPENTAX, Montvale, NJ).
Results
Across all subjects, low-to-moderate strength Spearman rho (rs) correlations were observed between the total VHI and the CPP and the CSID in both
speech and vowel contexts and for the CPP SD from continuous speech (rs's ranging from −0.45 to −0.49 for VHI vs CPP; 0.47 for VHI vs CSID; −0.44 for VHI
vs CPP SD). Several other measures obtained from spectral or cepstral analyses also
were observed to correlate with total VHI, although increased variability in the strength,
direction, and overall significance of these other variables was observed depending
on gender and elicited context.
Conclusions
Voice-related disablement occurs within a context. In contrast, impairment-level measures
of phonatory function (like the spectral and cepstral measures included in this study)
are by nature decontextualized and appear to correlate low-to-moderately with quality
of life measures like the VHI. Therefore, spectral and cepstral acoustic measures
and the VHI should be viewed as providing relatively unique, meaningful, and complementary
information.
Key Words
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Article info
Publication history
Published online: April 02, 2014
Accepted:
December 11,
2013
Identification
Copyright
© 2014 The Voice Foundation. Published by Elsevier Inc. All rights reserved.
