Summary
Introduction
Acoustic Voice Quality Index (AVQI) is a multiparametric construct of voice quality
recognized for its clinical and research applications around the globe. This study
aimed to review the validity and diagnostic accuracy of AVQI (v02&03) and determine
the effects of age and gender.
Methods
This is a systematic review and meta-analysis registered with the PROSPERO registry.
The authors searched two databases (PubMed and Cochrane Library database) for relevant
studies. Studies selected for the systematic review were grouped based on study objectives.
To determine the quality of the selected studies, the authors utilized the QUADAS-2
tool.
Results
Meta-analysis of seven studies on AVQIv02 revealed a diagnostic threshold ranging
from 2.72 to 3.33 for AVQIv02. In comparison, eight studies investigating AVQIv03
suggested a diagnostic threshold ranging from 1.33 to 3.15 for AVQIv03. Altogether,
these studies demonstrated a pooled sensitivity and specificity of 0.85 and 0.92 for
AVQIv02 and 0.82 and 0.92 for AVQIv03. The Area under the Curve was slightly better
for AVQIv03 (0.94) than AVQIv02 (0.92). Three studies investigating the effect of
age and gender on AVQI had a consensus that AVQI is independent of gender. However,
findings were contradictory about the impact of age on AVQI.
Conclusions
AVQI is found to be a valid tool for the assessment of voice quality. AVQIv03 is slightly
better than AVQIv02 in its diagnostic accuracy. AVQI is independent of gender. Because
of the contradictory evidence, additional research on the effects of age on AVQI is
necessary.
Key words
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REFERENCES
- Multi parametric voice assessment: Sri Ramachandra university protocol.Indian J Otolaryngol Head Neck Surg. 2014; 66: 246-251https://doi.org/10.1007/s12070-011-0460-y
- A basic protocol for functional assessment of voice pathology, especially for investigating the efficacy of (phonosurgical) treatments and evaluating new assessment techniques.Eur Arch Otorhinolaryngol. 2001; 258: 77-82https://doi.org/10.1007/s004050000299
- Recommended protocols for instrumental assessment of voice: american speech-language-hearing association expert panel to develop a protocol for instrumental assessment of vocal function.Am J Speech Lang Pathol. 2018; 27: 887-905https://doi.org/10.1044/2018_AJSLP-17-0009
- Acoustic measurement of overall voice quality: a meta-analysis.J Acoust Soc Am. 2009; 126: 2619-2634https://doi.org/10.1121/1.3224706
- The dysphonia severity index.J Speech Lang Hear Res. 2000; 43: 796-809https://doi.org/10.1044/jslhr.4303.796
- Objective acoustic and aerodynamic measures of breathiness in paralytic dysphonia.Eur Arch Otorhinolaryngol. 2003; 260: 175-182https://doi.org/10.1007/s00405-002-0542-2
- Student research award 1999: comparative contrast of voice measurements.Otolaryngology–Head and Neck Surgery. 2000; 123: 164-169https://doi.org/10.1067/mhn.2000.107682
- Objective voice analysis for dysphonic patients.J Voice. 2001; 15: 529-542https://doi.org/10.1016/S0892-1997(01)00053-4
- Correlation of instrumental voice evaluation with perceptual voice analysis using a modified visual analog scale.Folia Phoniatr Logop. 2002; 54: 271-281https://doi.org/10.1159/000066150
- Laryngeal Function and Voice Disorders Basic Science to Clinical Practice.Thieme, 2019
- 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
- Spectral-cepstral estimation of dysphonia severity: external validation.Ann Otol Rhinol Laryngol. 2013; 122https://doi.org/10.1177/000348941312200108
- Objective dysphonia measures in the program praat: smoothed cepstral peak prominence and acoustic voice quality index.J Voice. 2015; 29: 35-43https://doi.org/10.1016/j.jvoice.2014.06.015
- Validation of the acoustic voice quality index version 03.01 and acoustic breathiness index in German.J Voice. 2020; 34: e17-157.e25https://doi.org/10.1016/j.jvoice.2018.07.026
- The improvement of internal consistency of the acoustic voice quality index.Am J Otolaryngol. 2015; 36: 647-656https://doi.org/10.1016/j.amjoto.2015.04.012
- 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
- A comparative study on acoustic voice quality index between the subjects with spasmodic dysphonia and normophonia.Indian J Otolaryngol Head Neck Surg. 2021; (Published online February 28)https://doi.org/10.1007/s12070-021-02448-5
- Evaluation of the questionnaire on voice self-concept by ENT tumor patients.Laryngo-Rhino-Otologie. 2019; 98: 339-344https://doi.org/10.1055/a-0816-5728
- Objective analysis of voice quality in patients with thyroid pathology.Clin Otolaryngol. 2022; 47: 81-87https://doi.org/10.1111/coa.13860
- Auditory-perceptual and acoustic methods in measuring dysphonia severity of Korean speech.J Voice. 2016; 30: 587-594https://doi.org/10.1016/j.jvoice.2015.06.011
- Application of the acoustic voice quality index for objective measurement of dysphonia severity.Acta Otorrinolaringol (English Edition). 2017; 68: 204-211https://doi.org/10.1016/j.otoeng.2017.06.007
- Questionnaire for the assessment of the voice self-concept in a neurological practice : Applicability for the identification of patients with high consultation needs.Nervenarzt. 2019; 90: 601-608https://doi.org/10.1007/s00115-018-0642-x
- Dysphonia in extremely preterm children: a longitudinal observation.Logoped Phoniatr Vocol. 2015; 41: 1-5https://doi.org/10.3109/14015439.2015.1054307
- Objective assessment of pediatric voice disorders with the acoustic voice quality index.J Voice. 2012; 26: 672.e1-672.e7https://doi.org/10.1016/j.jvoice.2012.02.002
- The effect of supraclavicular radiotherapy on acoustic voice quality index (AVQI), spectral amplitude and perturbation values.J Voice. 2020; 34: 649.e7-649.e13https://doi.org/10.1016/j.jvoice.2019.01.003
- The acoustic voice quality index: toward improved treatment outcomes assessment in voice disorders.J Commun Disord. 2010; 43: 161-174https://doi.org/10.1016/j.jcomdis.2009.12.004
- Preliminary study of Novafon local vibration voice therapy for dysphonia treatment.Logop Phoniatr Vocol. 2020; 45: 1-9https://doi.org/10.1080/14015439.2018.1453541
- Validation of the acoustic voice quality index in the japanese language.J Voice. 2017; 31: 260.e1-260.e9https://doi.org/10.1016/j.jvoice.2016.05.010
- Effect of three semi-occluded vocal tract therapy programmes on the phonation of patients with dysphonia: lip trill, water-resistance therapy and straw phonation.Int J Lang Commun Disord. 2019; 54: 50-61https://doi.org/10.1111/1460-6984.12431
- The efficacy of the NHS waterpipe in superficial hydration for people with healthy voices: effects on acoustic voice quality, phonation threshold pressure and subjective sensations.J Voice. 2021; (Published online October)https://doi.org/10.1016/j.jvoice.2021.08.012
- Epidemiological patterns and treatment outcomes in a private practice community voice clinic.J Voice. 2020; (Published online July)https://doi.org/10.1016/j.jvoice.2020.06.025
- Multidimensional evaluation of voice outcomes following total laryngectomy: a prospective multicenter cohort study.Eur Arch Otorhinolaryngol. 2021; 278: 1209-1222https://doi.org/10.1007/s00405-020-06216-z
- Acoustic voice quality index as a potential tool for voice screening.J Voice. 2021; 35: 226-232https://doi.org/10.1016/j.jvoice.2019.08.017
- The usefulness of auditory perceptual assessment and acoustic analysis as a screening test for voice problems.Folia Phoniatr Logop. 2021; 73: 34-41https://doi.org/10.1159/000504220
- Exploring the feasibility of the combination of acoustic voice quality index and glottal function index for voice pathology screening.Eur Arch Otorhinolaryngol. 2019; 276: 1737-1745https://doi.org/10.1007/s00405-019-05433-5
- Vocal fatigue in prospective vocal professionals.J Voice. 2021; 35: 247-258https://doi.org/10.1016/j.jvoice.2019.08.015
- Vocal quality in theater actors.J Voice. 2017; 31: 510.e7-510.e14https://doi.org/10.1016/j.jvoice.2016.11.008
- Vocal quality, symptoms, and habits in musical theater actors.J Voice. 2020; (Published online July 2)https://doi.org/10.1016/j.jvoice.2020.05.019
- The performance of the acoustic voice quality index and acoustic breathiness index in synthesized voices.J Voice. 2021; (Published online July)https://doi.org/10.1016/j.jvoice.2021.05.005
- Accuracy of acoustic voice quality index captured with a smartphone – measurements with added ambient noise.J Voice. 2021; (Published online March 4)https://doi.org/10.1016/j.jvoice.2021.01.025
- Are acoustic markers of voice and speech signals affected by nose-and-mouth-covering respiratory protective masks?.J Voice. 2021; (Published online February)https://doi.org/10.1016/j.jvoice.2021.01.013
- Measuring voice quality parameters after speaker pseudonymization.in: Interspeech 2021. ISCA. 2021: 1019-1023https://doi.org/10.21437/Interspeech.2021-26
- Imitating dysphonic voice: a suitable technique to create speech stimuli for spoken language processing tasks?.Logop Phoniatr Vocol. 2020; 45: 143-150https://doi.org/10.1080/14015439.2019.1659410
- Diagnostic accuracy of dysphonia classification of DSI and AVQI.Laryngoscope. 2019; 129: 692-698https://doi.org/10.1002/lary.27350
- A comparison of dysphonia severity index and acoustic voice quality index measures in differentiating normal and dysphonic voices.Eur Arch Otorhinolaryngol. 2018; 275: 949-958https://doi.org/10.1007/s00405-018-4903-x
- Comparison of two multiparameter acoustic indices of dysphonia severity: the acoustic voice quality index and cepstral spectral index of dysphonia.J Voice. 2018; 32: 515.e1-515.e13https://doi.org/10.1016/j.jvoice.2017.06.012
- The acoustic voice quality index, version 03.01, in French and the voice handicap index.J Voice. 2020; 34: 646.e1-646.e10https://doi.org/10.1016/j.jvoice.2018.11.017
- Accuracy of acoustic voice quality index and its isolated acoustic measures to discriminate the severity of voice disorders.J Voice. 2020; (Published online August)https://doi.org/10.1016/j.jvoice.2020.08.010
- The usefulness of auditory perceptual assessment and acoustic analysis for classifying the voice severity.J Voice. 2020; 34: 884-893https://doi.org/10.1016/j.jvoice.2019.04.013
- Assessment of voice quality: current state-of-the-art.Auris Nasus Larynx. 2015; 42: 183-188https://doi.org/10.1016/j.anl.2014.11.001
- Acoustic voice quality index and acoustic breathiness index as two examples for strengths and weaknesses of free software in medicine.Biomed Signal Process Control. 2020; 59101938https://doi.org/10.1016/j.bspc.2020.101938
- The acoustic voice quality index. Toward expanded measurement of dysphonia severity in German subjects.HNO. 2012; 60: 715-720https://doi.org/10.1007/s00106-012-2499-9
- Validation of the acoustic voice quality index version 03.01 and the acoustic breathiness index in the Spanish language.Ann Otol Rhinol Laryngol. 2018; 127: 317-326https://doi.org/10.1177/0003489418761096
- Validation of the acoustic voice quality index, version 03.01, to the Brazilian Portuguese language.J Voice. 2021; 35: 160.e15-160.e21https://doi.org/10.1016/j.jvoice.2019.07.024
- Validation of the acoustic voice quality index (AVQI) Version 03.01 in Italian.J Voice. 2021; (Published online March)https://doi.org/10.1016/j.jvoice.2021.02.029
- 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
- The acoustic voice quality index version 02.02 in the Finnish-speaking population.Logop Phoniatr Vocol. 2020; 45: 49-56https://doi.org/10.1080/14015439.2018.1556332
- Validation of the acoustic voice quality index in the Korean language.J Voice. 2019; 33: 948.e1-948.e9https://doi.org/10.1016/j.jvoice.2018.06.007
- Validation of acoustic voice quality index version 3.01 and acoustic breathiness index in Korean population.J Voice. 2021; 35: 660.e9-660.e18https://doi.org/10.1016/j.jvoice.2019.10.005
- Diagnostic accuracy of acoustic voice quality index version 02.03 in discriminating across the perceptual degrees of dysphonia severity in Kannada language.J Voice. 2021; 35: 159.e11-159.e18https://doi.org/10.1016/j.jvoice.2019.07.010
- Validation of the acoustic voice quality index in the Lithuanian language.J Voice. 2017; 31: 257.e1-257.e11https://doi.org/10.1016/j.jvoice.2016.06.002
- Validation and test-retest reliability of acoustic voice quality index version 02.06 in the Turkish language.J Voice. 2020; (Published online September)https://doi.org/10.1016/j.jvoice.2020.08.021
- Validation of the acoustic voice quality index, version 03.01, in French.J Voice. 2020; 34: 646.e11-646.e26https://doi.org/10.1016/j.jvoice.2018.12.008
- Influence of the voice sample length in perceptual and acoustic voice quality analysis.J Voice. 2020; (Published online August)https://doi.org/10.1016/j.jvoice.2020.07.010
- The acoustic breathiness index (ABI): a multivariate acoustic model for breathiness.J Voice. 2017; 31: 511.e11-511.e27https://doi.org/10.1016/J.JVOICE.2016.11.017
- The validity of the acoustic breathiness index in the evaluation of breathy voice quality: a meta-analysis.Clin Otolaryngol. 2021; 46: 31-40https://doi.org/10.1111/coa.13629
- Comparison of two versions of the acoustic voice quality index for quantification of dysphonia severity.J Voice. 2020; 34: 489.e11-489.e19https://doi.org/10.1016/j.jvoice.2018.11.013
- The PRISMA 2020 statement: an updated guideline for reporting systematic reviews.BMJ. 2021; (Published online March 29n71)https://doi.org/10.1136/bmj.n71
- Shades of grey: guidelines for working with the grey literature in systematic reviews for management and organizational studies.Int J Manag Rev. 2017; 19https://doi.org/10.1111/ijmr.12102
- How scientific papers mention grey literature: a scientometric study based on Scopus data.Collection and Curation. 2021; 40: 77-82https://doi.org/10.1108/CC-12-2019-0044
- Grey literature in systematic reviews: a cross-sectional study of the contribution of non-English reports, unpublished studies and dissertations to the results of meta-analyses in child-relevant reviews.BMC Med Res Method. 2017; 17https://doi.org/10.1186/s12874-017-0347-z
- Rayyan—a web and mobile app for systematic reviews.Systematic Reviews. 2016; 5https://doi.org/10.1186/s13643-016-0384-4
- QUADAS-2: a revised tool for the quality assessment of diagnostic accuracy studies.Ann Intern Med. 2011; 155: 529https://doi.org/10.7326/0003-4819-155-8-201110180-00009
- Acoustic analysis of voice in singers: a systematic review.J Speech Lang Hear Res. 2018; 61: 40-51https://doi.org/10.1044/2017_JSLHR-S-17-0145
- Meta-DiSc: a software for meta-analysis of test accuracy data.BMC Med Res Method. 2006; 6https://doi.org/10.1186/1471-2288-6-31
Review Manager (RevMan). Published online 2020.
- Systematic review and meta-analysis of studies evaluating diagnostic test accuracy: a practical review for clinical researchers-part I. General guidance and tips.Korean J Radiol. 2015; 16: 1175https://doi.org/10.3348/kjr.2015.16.6.1175
- Assessing heterogeneity in meta-analysis: Q statistic or I2 index?.Psychol Methods. 2006; 11: 193-206https://doi.org/10.1037/1082-989X.11.2.193
- Systematic review and meta-analysis of studies evaluating diagnostic test accuracy: a practical review for clinical researchers-part II. statistical methods of meta-analysis.Korean J Radiol. 2015; 16: 1188https://doi.org/10.3348/kjr.2015.16.6.1188
- Measuring inconsistency in meta-analyses.BMJ. 2003; 327: 557-560https://doi.org/10.1136/bmj.327.7414.557
- When are summary ROC curves appropriate for diagnostic meta-analyses?.Stat Med. 2009; 28: 2653-2668https://doi.org/10.1002/sim.3631
- Properties of the summary receiver operating characteristic (SROC) curve for diagnostic test data.Stat Med. 2002; 21: 1237-1256https://doi.org/10.1002/sim.1099
- The measurement of observer agreement for categorical data.Biometrics. 1977; 33: 159-174
- Correlation coefficients.Anesth Analg. 2018; 126: 1763-1768https://doi.org/10.1213/ANE.0000000000002864
- The influence of gender and age on the acoustic voice quality index and dysphonia severity index: a normative study.J Voice. 2019; 33: 340-345https://doi.org/10.1016/j.jvoice.2017.11.011
- Effect of age and gender on acoustic voice quality index across lifespan: a cross-sectional study in Indian population.J Voice. 2020; (Published online June)https://doi.org/10.1016/j.jvoice.2020.05.025
- Effect of gender on acoustic voice quality index 02.03 and dysphonia severity index in Indian normophonic adults.Indian J Otolaryngol Head Neck Surg. 2021; (Published online July 2)https://doi.org/10.1007/s12070-021-02712-8
- Perceptual evaluation of voice quality: review, tutorial, and a framework for future research.J Speech Lang Hear Res. 1993; 36: 21-40https://doi.org/10.1044/jshr.3601.21
- A Case of Specificity: how does the acoustic voice quality index perform in normophonic subjects?.Appl Sci. 2019; 9: 2527https://doi.org/10.3390/app9122527
- Multiparameter voice assessment in dysphonics: correlation between objective and perceptual parameters.J Voice. July 2020; (Published online)https://doi.org/10.1016/j.jvoice.2020.06.009
- Comparing measures of voice quality from sustained phonation and continuous speech.J Speech Lang Hear Res. 2016; 59: 994-1001https://doi.org/10.1044/2016_JSLHR-S-15-0307
- The effect of the speech task characteristics on perceptual judgment of mild to moderate dysphonia: a methodological study.Folia Phoniatr Logop. 2018; 70: 156-164https://doi.org/10.1159/000492219
- Prediction of voice disorder severity: contributions from sustained vowels and continuous speech.in: 11th International Symposium on Chinese Spoken Language Processing (ISCSLP). IEEE. 2018: 290-294https://doi.org/10.1109/ISCSLP.2018.8706612
- Sustained vowels and continuous speech in the auditory-perceptual evaluation of dysphonia severity.J Soc Bras Fonoaudiol. 2012; 24: 107-112https://doi.org/10.1590/S2179-64912012000200003
- The value of the acoustic voice quality index as a measure of dysphonia severity in subjects speaking different languages.Eur Arch Otorhinolaryngol. 2013; 271: 1609-1619https://doi.org/10.1007/s00405-013-2730-7
- Test-retest variability and internal consistency of the acoustic voice quality index.HNO. 2013; 61: 399-403https://doi.org/10.1007/s00106-012-2649-0
- Clinical Research in Communication Disorders: Principles and Strategies.4th ed. Plural Publishing, 2019
- Cepstral analysis of voice in healthy aged individuals.J Laryngol Voice. 2015; 5: 34https://doi.org/10.4103/2230-9748.183963
- The effect of age and vocal task on cepstral/spectral measures of vocal function in adult males.Clin Linguist Phon. 2015; 29: 415-423https://doi.org/10.3109/02699206.2015.1005673
- Phonatory stability of voice in children.in: Proceedings of Frontiers of Research in Speech and Music. 2007: 85-88
- Changes in acoustic characteristics of the voice across the life span: measures from individuals 4–93 years of age.J Speech Lang Hear Res. 2011; 54: 1011-1021https://doi.org/10.1044/1092-4388(2010/10-0036
Article info
Publication history
Published online: April 20, 2022
Accepted:
March 18,
2022
Publication stage
In Press Corrected ProofIdentification
Copyright
© 2022 The Voice Foundation. Published by Elsevier Inc. All rights reserved.
