Summary
Objectives
This retrospective study examines the influence of voice quality in connected speech
(CS) and sustained vowels (SV) on the voice-related disability in patients’ daily
living documented by Voice Handicap Index-10 (VHI-10).
Methods
A total of 500 voice recordings of CS and SV samples from 338 patients with voice
disturbances were included, along with the patients' age, diagnoses, maximum phonation
time, and VHI-10. Dataset-1 comprised of 338 untreated patients, whereas Dataset-2
included 162 patients before and after phonosurgeries. As a preliminary study, the
concurrent and diagnostic validities based on auditory-perceptual judgments were examined
for cepstral peak prominence (CPP) and CPP smoothed (CPPS) for CS and SV tasks. Next,
simple correlations and multivariate regression analyses (MRA) were performed to identify
which of the acoustic measures for the CS or SV tasks significantly influenced the
total score or improvement of VHI-10.
Results
The preliminary study confirmed high correlations with hoarseness levels as well as
the excellent diagnostic accuracy of CPP and CPPS for both CS and SV tasks.
In Dataset-1, the simple correlations and MRA results showed that cepstral measures
in both tasks demonstrated moderate correlations with, and significant contribution
to the total score of VHI-10, respectively. However, in Dataset-2, the changes of
cepstral measures, as well as the median pitch after phonosurgeries in the CS tasks
only, showed significant contributions to the improvement of VHI-10.
Conclusion
The study demonstrated that the hoarseness levels in both the CS and SV tasks equivalently
influenced the VHI-10 scores, and that the post-surgical change of voice quality only
in the CS tasks influenced the improvement of voice-related disability in daily living.
Key words
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to Journal of VoiceAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
REFERENCES
- Psycho-acoustic evaluation of voice.in: Arnold G Winckel F Wyke B Disorders of Human Communication 5. Clinical Examination of Voice. Springer-Verlag, Vienna, Austria1981: 81-84
- Differential diagnosis of hoarseness.Folia Phoniatr (Basel). 1969; 21: 9-19https://doi.org/10.1159/000263230
- Consensus auditory-perceptual evaluation of voice: development of a standardized clinical protocol.Am J Speech-Language Pathol. 2009; 18: 124-132https://doi.org/10.1044/1058-0360(2008/08-0017
- Perceptual assessment of voice quality: past, present, and future.Perspect Voice Voice Disord. 2010; 20: 62https://doi.org/10.1044/vvd20.2.62
- Perceptual evaluation of voice quality: review, tutorial, and a framework for future research.J Speech Hear Res. 1993; 36: 21-40
- Some acoustic measures of the fundamental periodicity of normal and pathologic larynges.J Acoust Soc Am. 1963; 35: 344-353https://doi.org/10.1121/1.1918465
- Vowel amplitude modulations in patients with laryngeal diseases.J Acoust Soc Am. 1969; 45: 839-844https://doi.org/10.1121/1.1911554
- Application of some acoustic measures for the evaluation of laryngeal dysfunction.Stud Phonol. 1973; 7: 17-23
- Cepstrum analysis of pathologic voices.J Phon. 1986; 14: 501-508
- Harmonics-to-noise ratio as an index of the degree of hoarseness.J Acoust Soc Am. 1982; 71: 1544-1549https://doi.org/10.1121/1.387808
- Vocal shimmer in sustained phonation of normal and pathologic voice.Ann Otol Rhinol Laryngol. 1976; 85: 377-381https://doi.org/10.1177/000348947608500308
- Normalized noise energy as an acoustic measure to evaluate pathologic voice.J Acoust Soc Am. 1986; 80: 1329-1334https://doi.org/10.1121/1.394384
- Acoustic correlates of breathy vocal quality.J Speech Hear Res. 1994; 37: 769-778https://doi.org/10.1044/jshr.3302.298
- Acoustic correlates of breathy vocal quality: dysphonic voices and continuous speech.J Speech Hear Res. 1996; 39: 311-321https://doi.org/10.1044/jshr.3902.311
- Consistency and reliability of voice quality ratings for different types of speech fragments.J Speech Hear Res. 1994; 37: 985-1000https://doi.org/10.1044/jshr.3705.985
- Acoustic discrimination of pathological voice: sustained vowels versus continuous speech.J Speech Lang Hear Res. 2001; 44: 327-339https://doi.org/10.1044/1092-4388(2001/027
- Acoustic analyses of sustained and running voices from patients with laryngeal pathologies.J Voice. 2008; 22: 1-9https://doi.org/10.1016/j.jvoice.2006.08.003
- Long-term average speech spectra for normal and hearing-imparied adolescents.J Acoust Soc Am. 1982; 71: 196-202https://doi.org/10.1121/1.387347
- Analysis, synthesis, and perception of voice quality variations among female and male talkers.J Acoust Soc Am. 1990; 87: 820-857https://doi.org/10.1121/1.398894
- Acoustic recognition of voice disorders: a comparative study of running speech versus sustained vowels.J Acoust Soc Am. 1990; 87: 2218-2224https://doi.org/10.1121/1.399189
- Perceptual and acoustic correlates of abnormal voice qualities.Acta Otolaryngol. 1941; 90: 441-451https://doi.org/10.3109/00016488009131746
- Toward improved ecological validity in the acoustic measurement of overall voice quality: combining continuous speech and sustained vowels.J Voice. 2010; 24: 540-555https://doi.org/10.1016/j.jvoice.2008.12.014
- Quantifying dysphonia severity using a spectral/cepstral-based acoustic index: comparisons with auditory-perceptual judgements from the CAPE-V.Clin Linguist Phon. 2010; 24: 742-758https://doi.org/10.3109/02699206.2010.492446
- External validation of the acoustic voice quality index version 03.01 with extended representativity.Ann Otol Rhinol Laryngol. 2016; 125: 571-583https://doi.org/10.1177/0003489416636131
- Voice-related patient-reported outcome measures: a systematic review of instrument development and validation.J Speech Lang Hear Res. 2017; 60: 62-88https://doi.org/10.1044/2016_JSLHR-S-16-0022
- The voice handicap index (VHI).Am J Speech-Language Pathol. 1997; 6: 66-70https://doi.org/10.1044/1058-0360.0603.66
- Development and validation of the voice handicap index-10.Laryngoscope. 2004; 114: 1549-1556https://doi.org/10.1097/00005537-200409000-00009
- Multiparameter voice assessment for voice disorder patients: a correlation analysis between objective and subjective parameters.J Voice. 2014; 28: 770-774https://doi.org/10.1016/j.jvoice.2014.03.014
- The voice handicap index: correlation between subjective patient response and quantitative assessment of voice.J Voice. 2007; 21: 623-631https://doi.org/10.1016/j.jvoice.2006.04.005
- Correlation between acoustic parameters and voice handicap index in dysphonic teachers.Folia Phoniatr Logop. 2010; 62: 55-60https://doi.org/10.1159/000239064
- Relationship between acoustic measurements and self-evaluation in patients with voice disorders.J Voice. 2017; 31: 119.e1-119.e10https://doi.org/10.1016/j.jvoice.2016.02.021
- Correlation between voice handicap index and voice laboratory measurements in dysphonic patients.Eur Arch Otorhinolaryngol. 2002; 259: 97-99https://doi.org/10.1007/s004050100405
- Correlation of VHI-30 to acoustic measurements across three common voice disorders.J Voice. 2017; 31: 34-40https://doi.org/10.1016/j.jvoice.2016.02.016
- The relationship between VHI scores and specific acoustic measures of mildly disordered voice production.J Voice. 2006; 20: 308-317https://doi.org/10.1016/j.jvoice.2005.03.006
- The acoustic voice quality index, version 03.01, in French and the voice handicap index.J Voice. 2018; : 1-10https://doi.org/10.1016/j.jvoice.2018.11.017
- Correlation between the voice handicap index and voice laboratory measurements after phonosurgery.Ear Nose Throat J. 2010; 89: 183-188
- Voice deviation, dysphonia risk screening and quality of life in individuals with various laryngeal diagnoses.Clinics. 2018; 73: 1-6https://doi.org/10.6061/clinics/2018/e174
- Correlation of VHI-10 to voice laboratory measurements across five common voice disorders.J Voice. 2014; 28: 440-448https://doi.org/10.1016/j.jvoice.2013.10.023
- Exploring the relationship between spectral and cepstral measures of voice and the voice handicap index (VHI).J Voice. 2014; 28: 430-439https://doi.org/10.1016/j.jvoice.2013.12.008
- Characteristics of the voice handicap index for patients with unilateral vocal fold paralysis who underwent arytenoid adduction.J Voice. 2019; : 1-6https://doi.org/10.1016/j.jvoice.2018.12.012
- Objective voice parameters and self-perceived handicap in dysphonia.Folia Phoniatr Logop. 2010; 62: 303-307https://doi.org/10.1159/000287715
- Acoustic voice analysis and maximum phonation time in relation to voice handicap index score and larynx disease.J Voice. 2020; 34: 161.e27-161.e35https://doi.org/10.1016/j.jvoice.2018.07.002
- Correlation between the voice handicap index and voice measurements in four groups of patients with dysphonia.Otolaryngol Head Neck Surg. 2009; 141: 762-769https://doi.org/10.1016/j.otohns.2009.08.021
- Multiparametric assessment of voice quality and quality of life in patients undergoing microlaryngeal surgery-correlation between subjective and objective methods.J Voice. 2018; 32: 257.e21-257.e30https://doi.org/10.1016/j.jvoice.2017.04.016
- The acoustic voice quality index version 03.01 for the Japanese-speaking population.J Voice. 2019; 33: 125.e1-125.e12https://doi.org/10.1016/j.jvoice.2017.10.003
- Examination -collecting information-.in: Hirose H ST No Tame No Onsei Shogai Shinryo Manual (Clinical Manual of Voice Disorders for Speech Therapists). Interuna Publishers Inc., Tokyo, Japan2008: 13-32
- Praat, a system for doing phonetics by computer.Glot Int. 2001; 5: 341-345
- Intertext variability of smoothed cepstral peak prominence, methods to control it, and its diagnostic properties.J Voice. 2020; 34: 305-319https://doi.org/10.1016/j.jvoice.2018.09.021
- The measurement of observer agreement for categorical data.Biometrics. 1977; 33: 159-174https://doi.org/10.2307/2529310
The Japan Society of Logopedics and Phoniatrics. The Japanese Translation of Voice Handicap Index. Available at: http://www.jslp.org/pubcomm/vhi.pdf. Accessed December 24, 2020
- Japanese version of voice handicap index for subjective evaluation of voice disorder.J Voice. 2012; 26: 668.e15-668.e19https://doi.org/10.1016/j.jvoice.2011.11.005
- Index for rating diagnostic tests.Cancer. 1950; 3 (aid-cncr2820030106>3.0.co;2-3): 32-35https://doi.org/10.1002/1097-0142(1950)3:1<32
- Investigating Communication: An Introduction to Research Methods.Prentice-Hall, Englewood Cliffs, HJ, USA1991
- Mean fundamental frequency in connected speech and sustained vowel with and without a sentence-frame.Logoped Phoniatr Vocol. 2020; 45: 91-96https://doi.org/10.1080/14015439.2019.1637455
- Assessment of dysphonia using the Japanese version of the voice handicap index and determination of cutoff points for screening.J Voice. 2020; https://doi.org/10.1016/j.jvoice.2020.04.031
- Voice handicap index change following treatment of voice disorders.J Voice. 2000; 14: 619-623https://doi.org/10.1016/S0892-1997(00)80017-X
- Longitudinal analysis of voice handicap index in early glottic cancer patients treated with transoral laser microsurgery: age, gender, stage and time dependence.J Laryngol Otol. 2019; 133: 318-323https://doi.org/10.1017/S0022215119000392
- Patient characteristics and intervention effect as measured by voice handicap index.Logop Phoniatr Vocology. 2017; 42: 93-98https://doi.org/10.1080/14015439.2016.1219387
- Association between anxiety, type a personality, and treatment outcome of dysphonia due to benign causes.Otolaryngol Neck Surg. 2013; 148: 96-102https://doi.org/10.1177/0194599812465592
Article info
Publication history
Published online: December 26, 2020
Identification
Copyright
© 2020 The Voice Foundation. Published by Elsevier Inc. All rights reserved.