Outcomes Measurement in Voice Disorders: Application of an Acoustic Index of Dysphonia Severity Purpose The purpose of this experiment was to assess the ability of an acoustic model composed of both time-based and spectral-based measures to track change following voice disorder treatment and to serve as a possible treatment outcomes measure. Method A weighted, four-factor acoustic algorithm consisting of shimmer, pitch ... Research Article
Research Article  |   April 01, 2009
Outcomes Measurement in Voice Disorders: Application of an Acoustic Index of Dysphonia Severity
 
Author Affiliations & Notes
  • Shaheen N. Awan
    Bloomsburg University of Pennsylvania
  • Nelson Roy
    University of Utah
  • Contact author: Shaheen N. Awan, Department of Audiology and Speech Pathology, Bloomsburg University of Pennsylvania, Centennial Hall, 400 East Second Street, Bloomsburg, PA 17815-1301. E-mail: sawan@bloomu.edu.
Article Information
Speech, Voice & Prosodic Disorders / Voice Disorders / Hearing & Speech Perception / Acoustics / Speech, Voice & Prosody / Speech / Research Articles
Research Article   |   April 01, 2009
Outcomes Measurement in Voice Disorders: Application of an Acoustic Index of Dysphonia Severity
Journal of Speech, Language, and Hearing Research, April 2009, Vol. 52, 482-499. doi:10.1044/1092-4388(2008/08-0034)
History: Received February 10, 2008 , Accepted June 11, 2008
 
Journal of Speech, Language, and Hearing Research, April 2009, Vol. 52, 482-499. doi:10.1044/1092-4388(2008/08-0034)
History: Received February 10, 2008; Accepted June 11, 2008

Purpose The purpose of this experiment was to assess the ability of an acoustic model composed of both time-based and spectral-based measures to track change following voice disorder treatment and to serve as a possible treatment outcomes measure.

Method A weighted, four-factor acoustic algorithm consisting of shimmer, pitch sigma, the ratio of low-to-high frequency spectral energy, and a measure of the cepstral peak was used to predict dysphonia severity in pre- and post-treatment vowel samples from 88 women with primary muscle tension dysphonia treated by manual circumlaryngeal therapy. Predicted severity ratings were also compared to mean perceived severity ratings determined by a group of judges.

Results Predicted severity scores were strongly associated with perceived dysphonia severity ratings for pretreatment, posttreatment, and change in dysphonia severity. Analyses of the agreement between predicted and perceptual severity ratings indicated that the majority of differences were within ± 1 standard deviation from the mean difference. Acoustic predictions of perceived severity were observed to be most accurate for the midportion of the 7-point equal-appearing interval severity scale.

Conclusion The acoustic model and predicted dysphonia severity scores show promise as a sensitive and objective outcomes measure, even with extremely perturbed pre-treatment voice samples that would be difficult to analyze using traditional time-based perturbation measures.

Acknowledgments
Portions of this article were presented at the 2007 American Speech-Language-Hearing Association Convention in Boston, Massachusetts (November 2007).
We would like to thank James Hillenbrand for his insight regarding the acoustic analysis methods described herein. In addition, we would also like to thank Peter Bohling, Bloomsburg University of Pennsylvania, for his helpful comments and suggestions regarding the statistical results.
The first author, Shaheen N. Awan, acknowledges that he is the programmer and developer of all specific computer algorithms that were used for the acoustic analysis components of this article. At this time, the combined four-factor acoustic model described in this article is not included in any commercial software. Please contact Shaheen N. Awan regarding use of the computer programs described in this article.
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