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Doruk C, Mocchetti V, Rives H, Christos P, Rameau A. Correlations Between Anxiety and/or Depression Diagnoses and Dysphagia Severity. Laryngoscope 2024; 134:2115-2120. [PMID: 37942834 PMCID: PMC11006580 DOI: 10.1002/lary.31164] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Revised: 09/29/2023] [Accepted: 10/23/2023] [Indexed: 11/10/2023]
Abstract
OBJECTIVE An increased prevalence of mood and anxiety disorders in patients with dysphagia has been noted previously, but whether dysphagia severity may be exacerbated by anxiety and depression has never been studied before. The purpose of this study is to identify the effect of pre-existing diagnosis of anxiety and/or depression (anxiety/depression) on the Eating Assessment Tool (EAT-10), a validated patient-reported outcome measure for dysphagia. We hypothesized that patients with dysphagia and normal instrumental evaluation have higher EAT-10 score in the presence of pre-existing anxiety and depression. METHODS A retrospective chart review was conducted of patients seen at the multi-disciplinary dysphagia clinic of an urban academic institution. EAT-10 scores and pre-existing diagnoses of anxiety/depression were collected at the first visit with laryngologists. The two-sample t-test was used to compare mean EAT-10 scores between the anxiety/depression and no anxiety/depression groups, stratified by swallowing dysfunction etiology. RESULTS The study included 290 consecutive patients seen starting in January 2018. In this cohort, 60 (21%) had pre-existing anxiety, 49 (17%) depression, and 36 (12%) both. Overall, 59 patients had normal swallowing based on instrumental swallowing testing (flexible endoscopic evaluation of swallowing, videofluoroscopic swallow study, esophagram, or esophagoscopy). Among those, mean EAT-10 score was significantly higher in patients with anxiety and/or depression (n = 30) (14.63, SD = 11.42) compared to those with no anxiety and/or depression (n = 29) (8.93, SD = 6.59) (p = 0.023). CONCLUSION While anxiety/depression may aggravate dysphagia in patients with normal swallowing function, this correlation may not hold in those with objective swallowing dysfunction. LEVEL OF EVIDENCE 4 Laryngoscope, 134:2115-2120, 2024.
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Affiliation(s)
- Can Doruk
- Weill Cornell Medicine, Department of Otolaryngology-Head & Neck Surgery, Sean Parker Institute for the Voice, New York, NY
| | - Valentina Mocchetti
- Weill Cornell Medicine, Department of Otolaryngology-Head & Neck Surgery, Sean Parker Institute for the Voice, New York, NY
| | - Hal Rives
- Weill Cornell Medicine, Department of Otolaryngology-Head & Neck Surgery, Sean Parker Institute for the Voice, New York, NY
| | - Paul Christos
- Weill Cornell Medicine, Department of Population Health Sciences, New York, NY
| | - Anaïs Rameau
- Weill Cornell Medicine, Department of Otolaryngology-Head & Neck Surgery, Sean Parker Institute for the Voice, New York, NY
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Emshoff R, Astl M, Giotakis AI, Hupp LC, Kolk A. Factors associated with voice-related quality of life among patients with temporomandibular disorders. J Appl Oral Sci 2024; 32:e20230296. [PMID: 38536993 PMCID: PMC10984579 DOI: 10.1590/1678-7757-2023-0296] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2023] [Revised: 12/27/2023] [Accepted: 01/22/2024] [Indexed: 04/04/2024] Open
Abstract
BACKGROUND Research would be important for obtaining a better understanding of voice complaints among patients with temporomandibular disorders (TMD). OBJECTIVE The identification of predictors of voice disorders associated with TMD pain was made according to Diagnostic Criteria for TMD (DC/TMD) Axis I. METHODOLOGY Functional limitations were measured using the Jaw Functional Limitation Scales for mastication (JFLS-M), jaw mobility (JFLS-JM), and verbal and emotional expression (JFLS-VEE). Patients also completed the Hospital Anxiety and Depression Scale (HADS). The primary outcome was social-emotional and physical functioning as indicated by scores on the Voice-Related Quality of Life (V-RQOL) questionnaire. Multiple linear regression was used to model the relationship between the domains on the V-RQOL questionnaire and scores on the HADS and JFLS after adjusting for age, gender, DC/TMD diagnosis, pain intensity, and time since pain onset. RESULTS The HADS-D (B=-1.15; 95% CI, -1.718 to -0.587; p<.001) and JFLS-VEE (B=-0.22; 95% CI, -0.40 to -0.06; p=.008) were significant predictors of scores on the V-RQOL questionnaire. CONCLUSION Higher scores on depression measures and limitations in verbal and emotional expression could exacerbate voice problems among TMD pain patients. Future research should promote multidisciplinary treatments for TMD pain-related voice disorders.
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Affiliation(s)
- Rüdiger Emshoff
- University Clinic of Oral and Maxillofacial Surgery, Medical University of Innsbruck, Innsbruck, Austria
| | - Magdalena Astl
- Bachelor Program Speech and Language Therapy, University of Applied Sciences for Health Professions Upper Austria, Linz, Austria
| | - Aris Ioannis Giotakis
- Department of Otorhinolaryngology, Head and Neck Surgery, Medical University of Innsbruck, Innsbruck, Austria
| | - Linus Christian Hupp
- University Clinic of Oral and Maxillofacial Surgery, Medical University of Innsbruck, Innsbruck, Austria
| | - Andreas Kolk
- University Clinic of Oral and Maxillofacial Surgery, Medical University of Innsbruck, Innsbruck, Austria
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Gray H, Coman L, Walton C, Thorning S, Cardell E, Weir KA. A Comparison of Voice and Psychotherapeutic Treatments for Adults With Functional Voice Disorders: A Systematic Review. J Voice 2024; 38:542.e9-542.e27. [PMID: 34772593 DOI: 10.1016/j.jvoice.2021.09.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2021] [Revised: 09/13/2021] [Accepted: 09/15/2021] [Indexed: 10/19/2022]
Abstract
OBJECTIVE To examine the effect of traditional voice therapy and cognitive therapy on the voice and client-wellbeing outcomes in adults with functional voice disorders (FVD). METHODS A systematic review of English articles was conducted using Medline (Ovid), Embase (Elsevier), CINAHL (Ebsco), The Cochrane Central Register of Controlled Trials (CENTRAL), PsychInfo (Ebsco) and Speechbite from inception to current date. Additional studies were identified through bibliographies and authors were contacted when further information was required from an article. All study designs were included with pretest/posttest outcome measures related to voice. Independent extraction of studies was completed by three authors using predefined data fields and quality assessment tools. RESULTS Outcomes of 23 studies (2 RCTs and 21 cohort or case studies) are summarised using a narrative style due to heterogeneity of interventions and outcome scales used. Overall research quality of included studies was low, with many cohort and case studies lacking controls, blinding and robust outcome measures. CONCLUSIONS There are some benefits to pairing cognitive behavioural therapy (CBT) with traditional voice therapy for FVD including improved voice quality, psychosocial wellbeing and prevention of relapse. It is feasible to train speech-language pathologists (SLPs) in CBT-enhanced voice therapy. Further high-quality research is needed, however, to guide the clinical implementation of CBT for the management of FVD.
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Affiliation(s)
- Heidi Gray
- Speech Pathology Service, Gold Coast University Hospital, Gold Coast Health, Southport, Queensland, Australia.
| | - Leah Coman
- Speech Pathology Service, Gold Coast University Hospital, Gold Coast Health, Southport, Queensland, Australia
| | - Chloe Walton
- Speech Pathology Service, Gold Coast University Hospital, Gold Coast Health, Southport, Queensland, Australia
| | - Sarah Thorning
- Research Governance and Development, Gold Coast University Hospital, Gold Coast Health, Southport, Queensland, Australia
| | - Elizabeth Cardell
- School of Medicine and Dentistry; and Menzies Health Institute Queensland, Gold Coast campus, Griffith University, Southport, Queensland, Australia
| | - Kelly A Weir
- School of Health Sciences & Social Work; and Menzies Health Institute Queensland, Gold Coast campus, Griffith University, Southport, Queensland, Australia; Allied Health Research, Gold Coast Health, Southport, Queensland, Australia
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Mao K, Wu Y, Chen J. A systematic review on automated clinical depression diagnosis. NPJ MENTAL HEALTH RESEARCH 2023; 2:20. [PMID: 38609509 PMCID: PMC10955993 DOI: 10.1038/s44184-023-00040-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Accepted: 09/27/2023] [Indexed: 04/14/2024]
Abstract
Assessing mental health disorders and determining treatment can be difficult for a number of reasons, including access to healthcare providers. Assessments and treatments may not be continuous and can be limited by the unpredictable nature of psychiatric symptoms. Machine-learning models using data collected in a clinical setting can improve diagnosis and treatment. Studies have used speech, text, and facial expression analysis to identify depression. Still, more research is needed to address challenges such as the need for multimodality machine-learning models for clinical use. We conducted a review of studies from the past decade that utilized speech, text, and facial expression analysis to detect depression, as defined by the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), using the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guideline. We provide information on the number of participants, techniques used to assess clinical outcomes, speech-eliciting tasks, machine-learning algorithms, metrics, and other important discoveries for each study. A total of 544 studies were examined, 264 of which satisfied the inclusion criteria. A database has been created containing the query results and a summary of how different features are used to detect depression. While machine learning shows its potential to enhance mental health disorder evaluations, some obstacles must be overcome, especially the requirement for more transparent machine-learning models for clinical purposes. Considering the variety of datasets, feature extraction techniques, and metrics used in this field, guidelines have been provided to collect data and train machine-learning models to guarantee reproducibility and generalizability across different contexts.
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Affiliation(s)
- Kaining Mao
- Department of Electrical and Computer Engineering, University of Alberta, Edmonton, AB, T6G 2R3, Canada
| | - Yuqi Wu
- Department of Electrical and Computer Engineering, University of Alberta, Edmonton, AB, T6G 2R3, Canada
| | - Jie Chen
- Department of Electrical and Computer Engineering, University of Alberta, Edmonton, AB, T6G 2R3, Canada.
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Kim HB, Park YS, Lee JE, Han KD, Park YH. Study on relationship between self-recognition of voice disorder and mental health status: Korea National Health and Nutrition Examination Survey. J Affect Disord 2023; 338:482-486. [PMID: 37247786 DOI: 10.1016/j.jad.2023.05.082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Revised: 05/21/2023] [Accepted: 05/22/2023] [Indexed: 05/31/2023]
Abstract
BACKGROUND The voice has been thought to be associated with emotions, but conducting large-scale research on this relationship has some limitations. To overcome these limitations, questionnaires have been utilized as a research tool. METHODS A population-based cross-sectional study was done. A total of 15,977 participants completed questionnaires regarding self-recognition of voice disorder (SRVD), and mental health status. RESULTS 1053(6.6 %) participants answered that they had SRVD. In the multivariate Cox proportional hazard model, psychological stress (Hazard ratio (HR) = 1.371, 95 % confidence interval (CI) = 1.154-1.629), depressive symptoms (HR = 1.626, 95 % CI = 1.323-1.997), suicidal ideation (HR = 1.739, 95 % CI = 1.418-2.133), and suicide attempt (HR =2.206, 95 % CI = 1.067-4.56) were all associated with SRVD. In SRVD lasting over three weeks, psychological stress (HR = 1.604, 95 % CI = 1.278-2.014), depressive symptoms (HR = 1.807, 95 % CI = 1.384-2.36), and suicidal ideation (HR = 2.073, 95 % CI = 1.587-2.709) were also significant factors. As the number of mental health problems increased, the odds ratio of both SRVD (OR = 2.49, 95 % CI = 1.839-3.37) and SRVD lasting over three weeks (OR = 3.254, 95 % CI = 2.242-4.725) increased, respectively. LIMITATIONS SRVD and mental health status were judged only by simple questionnaires. Cross-sectional design and retrospective data could not draw causal relationships. CONCLUSIONS SRVD and SRVD lasting over three weeks had a significant relationship with mental health status, including psychological stress, depressive symptoms, and suicidal ideation. There is a need to consider psychiatric treatment for individuals who visit hospitals with voice disorders.
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Affiliation(s)
- Hyun-Bum Kim
- Department of Otorhinolaryngology-Head and Neck Surgery, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Youn-Sun Park
- Department of Otorhinolaryngology-Head and Neck Surgery, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Ju-Eun Lee
- Department of Otorhinolaryngology-Head and Neck Surgery, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Kyung-Do Han
- Department of Statistics and Actuarial Science, Soongsil University, Seoul, Republic of Korea
| | - Young-Hak Park
- Department of Otorhinolaryngology-Head and Neck Surgery, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
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Clunie GM, Belsi A, Roe JG, Sandhu G, McGregor A, Alexander CM. 'Is there something wrong with your voice?' A qualitative study of the voice concerns of people with laryngotracheal stenosis. INTERNATIONAL JOURNAL OF LANGUAGE & COMMUNICATION DISORDERS 2023; 58:376-389. [PMID: 36189991 DOI: 10.1111/1460-6984.12794] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Accepted: 09/09/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND Acquired laryngotracheal stenosis (LTS) is a rare condition that causes breathlessness and dyspnoea. Patients have reconstructive airway surgery to improve their breathing difficulties, but both LTS and the surgery can cause voice difficulties. The existing evidence base for management of voice difficulties for adults with LTS focuses on symptoms. There is limited information to provide clinical guidance for speech and language therapists (SLTs) and a limited understanding of the impact of voice changes on adults with LTS. AIM To investigate the lived experience of adults with laryngotracheal stenosis (LTS), who have had reconstructive surgery; here focussing on voice concerns with the aim of guiding clinical care for SLTs. METHODS AND PROCEDURES A phenomenological, qualitative study design was used. Focus groups and semi-structured interviews were completed with adults living with LTS who had had reconstructive surgery. Audio recordings were transcribed and inductive thematic analysis was used by the research team to identify themes and sub-themes. OUTCOMES AND RESULTS A total of 24 participants (five focus groups and two interviews) took part in the study before thematic saturation was identified in analysis. Three main themes were identified specific to the experience of living with LTS: the Medical, Physical and Emotional journey. All participants referenced voice difficulties as they related to each of these overall themes. Sub-themes directly related to voice included experience of surgery, information provision, staff expertise/complacency, symptoms, symptom management, identity, support networks, impact on life and living with a chronic condition. CONCLUSIONS AND IMPLICATIONS In this qualitative study participants have described the integral part voice difficulties play in their lived experience of LTS and reconstructive surgery. This is considered in the context of their clinical care and the need for individualised management and information provision throughout the course of their condition. The broader research literature relating to voice difficulties is explored with links made to people with LTS and recommendations made for future research into people living with LTS and dysphonia. WHAT THIS PAPER ADDS What is already known on this subject Adults with laryngotracheal stenosis (LTS) experience voice changes as a result of their condition, and the surgeries necessary as a treatment. These changes can lead to altered pitch, vocal fatigue, loss of pitch range and loss of volume control. Although there are known psychosocial implications both to living with a chronic condition and voice difficulties there has been no research exploring this in adults with LTS, and there is minimal clinical guidance for speech and language therapists (SLTs) working with these patients. What this paper adds to existing knowledge This research is the first study to explore the lived experience of adults with LTS who undergo reconstructive surgery, focusing on their voice concerns. This study demonstrates the multifactorial impacts of voice changes on all aspects of the lives of adults with LTS and the need for individualised information provision and clinical care to help support them. What are the potential or actual clinical implications of this work? Adults with LTS want expert SLTs to facilitate their care and support them throughout their LTS journey alongside other support networks. They want to be carefully prepared for reconstructive surgery and given clear information about symptoms and management of their voice difficulties. This has led to the reorganisation of the care pathway at our centre, and the introduction of a patient-led pretreatment session.
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Affiliation(s)
- Gemma M Clunie
- Department of Surgery & Cancer, Imperial College London, London, UK
- Caroline Therapies Department Guri, ENT Department, Imperial College Healthcare NHS Trust, London, UK
| | - Athina Belsi
- Department of Surgery & Cancer, Imperial College London, London, UK
| | - JustinW G Roe
- Department of Surgery & Cancer, Imperial College London, London, UK
- Caroline Therapies Department Guri, ENT Department, Imperial College Healthcare NHS Trust, London, UK
| | - Guri Sandhu
- Department of Surgery & Cancer, Imperial College London, London, UK
- Caroline Therapies Department Guri, ENT Department, Imperial College Healthcare NHS Trust, London, UK
| | - Alison McGregor
- Department of Surgery & Cancer, Imperial College London, London, UK
| | - Caroline M Alexander
- Department of Surgery & Cancer, Imperial College London, London, UK
- Caroline Therapies Department Guri, ENT Department, Imperial College Healthcare NHS Trust, London, UK
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Ostermann TA, Fuchs M, Hinz A, Engel C, Berger T. Associations of Personality, Physical and Mental Health with Voice Range Profiles. J Voice 2023:S0892-1997(22)00377-0. [PMID: 36599716 DOI: 10.1016/j.jvoice.2022.11.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Revised: 11/17/2022] [Accepted: 11/18/2022] [Indexed: 01/03/2023]
Abstract
OBJECTIVES There is evidence in the literature that voice characteristics are linked to mental and physical health. The aim of this explorative study was to determine associations between voice parameters measured by a voice range profile (VRP) and personality, mental and physical health. STUDY DESIGN Cross-sectional population-based study. METHODS As part of the LIFE-Adult-Study, 2639 individuals aged 18-80 years, randomly sampled from the general population, completed both speaking and singing voice tasks and answered questionnaires on depression, anxiety, life satisfaction, personality and quality of life. The voice parameters used were fundamental frequency, sound pressure level, their ranges and maximum phonation time. The associations were examined with the help of correlation and regression analyses. RESULTS Wider ranges between the lowest and highest frequency, between the lowest and highest sound pressure level and longer maximum phonation time were significantly correlated with extraversion and quality of life in both sexes, as well as openness and agreeableness in women. Smaller ranges and shorter maximum phonation time were significantly correlated with depression. Neuroticism in men was inversely correlated with the maximum phonation time. In the speaking VRP, the associations for sound pressure level were more pronounced than for the fundamental frequency. The same was true in reverse for the singing VRP. Few associations were found for anxiety, life satisfaction and conscientiousness. CONCLUSIONS Weak associations between voice parameters derived from the VRP and mental and physical health, as well as personality were seen in this exploratory study. The results indicate that the VRP measurements in a clinical context are not significantly affected by these parameters and thus are a robust measurement method for voice parameters.
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Affiliation(s)
- Thomas A Ostermann
- Phoniatrics and Audiology, Department of Otorhinolaryngology, University of Leipzig, Leipzig, Germany; LIFE Leipzig Research Centre for Civilization Diseases, University of Leipzig, Leipzig, Germany; Institute for Medical Informatics, Statistics and Epidemiology, University of Leipzig, Leipzig, Germany
| | - Michael Fuchs
- Phoniatrics and Audiology, Department of Otorhinolaryngology, University of Leipzig, Leipzig, Germany; LIFE Leipzig Research Centre for Civilization Diseases, University of Leipzig, Leipzig, Germany
| | - Andreas Hinz
- LIFE Leipzig Research Centre for Civilization Diseases, University of Leipzig, Leipzig, Germany; Department of Medical Psychology and Medical Sociology, University of Leipzig, Leipzig, Germany
| | - Christoph Engel
- LIFE Leipzig Research Centre for Civilization Diseases, University of Leipzig, Leipzig, Germany; Institute for Medical Informatics, Statistics and Epidemiology, University of Leipzig, Leipzig, Germany
| | - Thomas Berger
- Phoniatrics and Audiology, Department of Otorhinolaryngology, University of Leipzig, Leipzig, Germany; LIFE Leipzig Research Centre for Civilization Diseases, University of Leipzig, Leipzig, Germany.
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Song SA, Go CL, Acuna PB, De Guzman JKP, Sharma N, Song PC. Progressive Decline in Voice and Voice-Related Quality of Life in X-Linked Dystonia Parkinsonism. J Voice 2023; 37:134-138. [PMID: 33334627 PMCID: PMC10222671 DOI: 10.1016/j.jvoice.2020.11.014] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2020] [Revised: 11/24/2020] [Accepted: 11/24/2020] [Indexed: 01/11/2023]
Abstract
OBJECTIVE To characterize the evolution of swallowing and voice in patients with X-linked dystonia parkinsonism (XDP). STUDY DESIGN Retrospective case series. METHODS Retrospective review of 59 patients with XDP from January 2016 to January 2018. All patients underwent complete examinations and quality of life (QOL) surveys (Swallowing Quality of Life questionnaire [SWAL-QOL], Voice-Related Quality of Life [V-RQOL], and Voice Handicap Index [VHI]), and functional endoscopic examination of swallowing. We excluded patients with incomplete records or patients lost to follow-up. Univariate analysis was used to compare 2016 to 2018 Penetration-Aspiration Scale (PAS), SWAL-QOL, V-RQOL, and VHI scores. RESULTS Ten patients met the inclusion criteria. Nine patients had oromandibular dystonia. Voice-related measures significantly worsened with an increase in mean VHI from 81 to 109.9 (P = 0.026) and decrease in mean V-RQOL from 58 to 28 (P = 0.013). Vocal strain also significantly worsened 0.4 to 1.4 (P = 0.001). Mean PAS scores increased from 4.2 to 5.1 (P = 0.068) and mean SWAL-QOL decreased from 50.4 to 43.5 (P = 0.157). In the SWAL-QOL, the mean Eating Duration score worsened from 0.9 to 0.4 (P = 0.052) and Mental Health score declined from 10.1 to 6.1 (P = 0.077). CONCLUSIONS Both vocal strain and voice-related QOL measures considerably worsened over the 2-year interval in our limited group of XDP patients with no significant change in PAS scores or swallowing QOL. The findings demonstrated that the pace of disease affecting voice symptoms was different from swallowing symptoms in our study group and that changes in communication ability may be a more sensitive marker for disease progression than swallowing dysfunction.
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Affiliation(s)
- Sungjin A Song
- Department of Otolaryngology, Massachusetts Eye and Ear, Boston, Massachusetts; Department of Otolaryngology, Harvard Medical School, Boston, Massachusetts.
| | - Criscely L Go
- Department of Neurology, Jose Reyes Memorial Medical Center, Manila, Philippines; The Collaborative Center for X-linked Dystonia Parkinsonism, Department of Neurology, Massachusetts General Hospital, Boston, Massachusetts
| | - Patrick B Acuna
- The Collaborative Center for X-linked Dystonia Parkinsonism, Department of Neurology, Massachusetts General Hospital, Boston, Massachusetts
| | - Jan Kristopher Palentinos De Guzman
- Department of Neurology, Jose Reyes Memorial Medical Center, Manila, Philippines; The Collaborative Center for X-linked Dystonia Parkinsonism, Department of Neurology, Massachusetts General Hospital, Boston, Massachusetts
| | - Nutan Sharma
- The Collaborative Center for X-linked Dystonia Parkinsonism, Department of Neurology, Massachusetts General Hospital, Boston, Massachusetts
| | - Phillip C Song
- Department of Otolaryngology, Massachusetts Eye and Ear, Boston, Massachusetts; Department of Otolaryngology, Harvard Medical School, Boston, Massachusetts
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Shih DH, Liao CH, Wu TW, Xu XY, Shih MH. Dysarthria Speech Detection Using Convolutional Neural Networks with Gated Recurrent Unit. Healthcare (Basel) 2022; 10:healthcare10101956. [PMID: 36292403 PMCID: PMC9602047 DOI: 10.3390/healthcare10101956] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Revised: 10/02/2022] [Accepted: 10/05/2022] [Indexed: 11/04/2022] Open
Abstract
In recent years, due to the rise in the population and aging, the prevalence of neurological diseases is also increasing year by year. Among these patients with Parkinson’s disease, stroke, cerebral palsy, and other neurological symptoms, dysarthria often appears. If these dysarthria patients are not quickly detected and treated, it is easy to cause difficulties in disease course management. When the symptoms worsen, they can also affect the patient’s psychology and physiology. Most of the past studies on dysarthria detection used machine learning or deep learning models as classification models. This study proposes an integrated CNN-GRU model with convolutional neural networks and gated recurrent units to detect dysarthria. The experimental results show that the CNN-GRU model proposed in this study has the highest accuracy of 98.38%, which is superior to other research models.
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Affiliation(s)
- Dong-Her Shih
- Department of Information Management, National Yunlin University of Science and Technology, Douliu 64002, Taiwan
| | - Ching-Hsien Liao
- Department of Information Management, National Yunlin University of Science and Technology, Douliu 64002, Taiwan
| | - Ting-Wei Wu
- Department of Information Management, National Yunlin University of Science and Technology, Douliu 64002, Taiwan
- Correspondence:
| | - Xiao-Yin Xu
- Department of Information Management, National Yunlin University of Science and Technology, Douliu 64002, Taiwan
| | - Ming-Hung Shih
- Department of Electrical and Computer Engineering, Iowa State University, 2520 Osborn Drive, Ames, IA 50011, USA
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Welch B, Helou LB. Measuring Communicative Congruence and Communicative Dysphoria in a Sample of Individuals Without Voice Disorders. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2022; 65:3420-3437. [PMID: 36054879 DOI: 10.1044/2022_jslhr-21-00459] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
PURPOSE This study examines communicative congruence and communicative dysphoria in adults who deny having a voice disorder. Communicative congruence is the degree to which a person's communication is consistent with their sense of self/identity. Communicative dysphoria is the psychological entropy resulting from communicative incongruence. We propose that these experiences may influence patients' psychosocial well-being and are thus relevant to the field of speech-language pathology. We hypothesized that both constructs would be normally distributed with an inverse relationship. We also hypothesized that communicative congruence would predict scores on the Center for Epidemiological Studies-Depression (CES-D) scale, subscales of the Big Five Aspect Scales (BFAS; a personality measure), and achieve convergent validity with the Vocal Congruence Scale (VCS). METHOD Participants (adults 18-70 years) completed the BFAS, CES-D, VCS, and the Voice Handicap Index-10 (VHI-10) before recording a series of speech tasks. Participants' recordings were played back while they responded to questions probing their communicative congruence and communicative dysphoria. RESULTS The 196 participants were predominantly female (67.3%) and cisgender (96.4%). Communicative congruence was negatively skewed, and communicative dysphoria was normally distributed. Both variables significantly related to each other: More incongruence was associated with more dysphoria. Communicative congruence was inversely related to CES-D scores. The personality metatrait Plasticity related to communicative congruence, as did the domain of Extraversion and the aspects Withdrawal, Enthusiasm, and Assertiveness. Communicative congruence achieved high convergent validity with the VCS. CONCLUSIONS Counter to our hypothesis, participants reported more congruence than incongruence, but all other hypotheses were supported. Participants who reported incongruence were more likely to report symptoms of depression. These findings suggest that even in a predominantly cisgender cohort, some individuals' mental well-being might relate to how well their communication aligns with their identity. This work may inform future investigations into these constructs and their effects on voice therapy outcomes. SUPPLEMENTAL MATERIAL https://doi.org/10.23641/asha.20739967.
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Affiliation(s)
- Brett Welch
- Department of Communication Science and Disorders, School of Health and Rehabilitation Sciences, University of Pittsburgh, PA
| | - Leah B Helou
- Department of Communication Science and Disorders, School of Health and Rehabilitation Sciences, University of Pittsburgh, PA
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He W, Cao L, Liu R, Wu Y, Zhang W. Factors associated with internet use and health information technology use among older people with multi-morbidity in the United States: findings from the National Health Interview Survey 2018. BMC Geriatr 2022; 22:733. [PMID: 36068502 PMCID: PMC9446732 DOI: 10.1186/s12877-022-03410-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Accepted: 08/26/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The number of older adults with physical multi-morbidity is increasing. As Internet-based eHealth and mHealth increasingly require patients to use technology, it is important to examine the use of Internet/health information technology (HIT) among older adults with physical multi-morbidity. Here we examine the distribution of physical multi-morbidity, Internet use, and HIT use, and further explored the factors associated with Internet use and HIT use among older adults with physical multi-morbidity. METHODS One wave of data from the 2018 US National Health Interview Survey (NHIS) was analysed. We included respondents aged 65 years and older. We used 13 physical non-communicable diseases to measure physical multi-morbidity. Descriptive statistics and logistic regression models, with sociodemographic factors, health status, health insurance, health care service use, and satisfaction with health care as covariates, were used to examine the research questions. RESULTS Of 72,746 respondents in NHIS, 7060 were eligible for our analysis. 5380 (76.2%) eligible respondents had physical multi-morbidity in this study. Overall, 60% of older adults reported using the Internet, with 38.9% using eHealth services (defined as looking up health information online, filling a prescription, scheduling an appointment with a health care provider, or communicating with a health care provider via email). Gender, age, marital status, region, race, education, and family income were significant factors associated with the Internet and HIT use among people with multi-morbidity. The study also showed that after adjusting for confounders, good health status, having Medicare, receiving home care from a health professional, and low satisfaction with health care were positive predictors of the Internet and HIT use. CONCLUSIONS In summary, our study found that Internet and HIT use among older patients with chronic diseases is far from the Healthy People 2030 target. Internet and HIT use vary depending on a number of sociodemographic factors. Relevant influencing factors should be fully considered in health education interventions promoted.
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Affiliation(s)
- Wenbo He
- Institute of Hospital Management, West China Hospital of Sichuan University, Chengdu, Sichuan, China
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
| | - Liujiao Cao
- West China School of Nursing/West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Rui Liu
- Department of Rehabilitation Medicine Center, West China Hospital, Sichuan University, Chengdu, Sichuan, China
- Key Laboratory of Rehabilitation Medicine in Sichuan Province, Chengdu, Sichuan, China
| | - Yi Wu
- Department of Epidemiology, School of Public Health, Harbin Medical University, Harbin, Heilongjiang, China
| | - Wei Zhang
- West China Biomedical Big Data Center, West China Hospital of Sichuan University, Chengdu, Sichuan, China.
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Hoffmeister JD, Ulmschneider CL, Ciucci MR, McCulloch TM. Stress Effects on Pharyngeal Air Pressure and Upper Esophageal Sphincter Pressure During Phonation: The Influence of Vocal Tract Semi-Occlusion. J Voice 2022:S0892-1997(22)00222-3. [PMID: 36031506 PMCID: PMC9958265 DOI: 10.1016/j.jvoice.2022.07.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Revised: 07/21/2022] [Accepted: 07/22/2022] [Indexed: 11/15/2022]
Abstract
OBJECTIVES/HYPOTHESIS The objective of this study was to determine whether vocal tract semi-occlusion (SOVT) influenced stress effects on pharyngeal air pressure and upper esophageal sphincter (UES) pressure during phonation. Relationships between dysphonia and stress are well recognized but poorly understood. Stress effects act globally on the body, and may be observed beyond intrinsic laryngeal muscles to include pharyngeal muscles and the UES, which contribute to voice modulation. Phonation with SOVT may provide resistance to stress effects on the vocal tract. We hypothesized that stress effects on pharyngeal air pressure and UES pressure would be measurable with a high-resolution, 360° pressure catheter, and that stress effects would be impacted differently by occlusal and non-occlusal phonatory tasks. METHODS Ten healthy adults performed sustained vowel tasks (comfortable /a/, and loud /a/), and SOVT tasks (bilabial fricative and straw phonation). Each task was performed during a baseline condition, and during stress induced through a cold pressor task. Pharyngeal air pressure and UES pressure were measured via high-resolution manometry. Changes in pressure between baseline and stress were compared among phonatory tasks. RESULTS Stress-induced changes to UES pressure differed by phonatory task (P < 0.01). Stress increased UES pressures during vowels, but had no effect during bilabial fricative, and decreased UES pressures during straw phonation. Change in UES pressure with stress was greater for comfortable /a/ and loud /a/ than straw phonation (P = 0.048 and P = 0.019, respectively), and was not significantly different between comfortable /a/ or loud /a/ and bilabial fricative. Stress-induced changes in pharyngeal air pressure were not significantly different among tasks. CONCLUSIONS These findings help identify possible mechanisms underlying the relationship between stress and voice, and point to the utility of SOVT tasks for training vocal tract resistance to stress. This methodology provides a foundation for measuring changes to extra-laryngeal components of the vocal tract during phonation.
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Affiliation(s)
| | | | - Michelle R Ciucci
- University of Wisconsin, Department of Surgery-Otolaryngology; University of Wisconsin, Department of Communication Sciences and Disorders; University of Wisconsin, Neuroscience Training Program
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Enin K, Parikh A, Kallogjeri D, Naunheim MR, Huston MN. Correlation Between a Diagnosis of Anxiety or Depression and Initial VHI-10 Scores in Benign Dysphonia. Otolaryngol Head Neck Surg 2022; 167:725-730. [PMID: 35104179 DOI: 10.1177/01945998221074994] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE Anxiety and depression have demonstrated a positive correlation with vocal handicap among patients with benign causes of dysphonia. Our objective is to explore differences in initial Vocal Handicap Index-10 (VHI-10) scores between patients with a mental health history of anxiety or depression and those without. STUDY DESIGN Retrospective cohort study. SETTING Demographic data, diagnoses, and initial VHI-10 scores were collected for patients presenting with dysphonia to 2 tertiary laryngology clinics. METHODS A Kruskal-Wallis test and subsequent Mann-Whitney U test for pairwise comparisons were used to compare distribution of VHI-10 scores among patients with anxiety, depression, anxiety and depression, and no such conditions. Bonferroni correction was used to control for multiple comparisons. Robust regression was used for multivariable analysis. RESULTS A total of 620 cases of benign dysphonia were analyzed. Forty-two percent of the patient cohort had a preexisting diagnosis of anxiety (n = 121, 20%), depression (n = 64, 10%), or anxiety and depression (n = 74, 12%). VHI-10 scores were higher in patients with depression than in those without anxiety or depression (median difference, 4 [95% CI, 1-8]; P = .005) but did not differ significantly among the other groups. The effects of depression and anxiety status on initial VHI-10 scores among the causes of benign dysphonia varied. CONCLUSIONS Patients with a history of depression who presented with dysphonia had worse vocal handicap than those without anxiety/depression history. Future studies may clarify how optimization of anxiety and depression can affect patient-reported vocal handicap.
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Affiliation(s)
- Kwasi Enin
- Department of Otolaryngology-Head and Neck Surgery, Washington University School of Medicine in St Louis, St Louis, Missouri, USA
| | - Ayush Parikh
- Department of Otolaryngology-Head and Neck Surgery, Harvard Medical School, Boston, Massachusetts, USA
| | - Dorina Kallogjeri
- Department of Otolaryngology-Head and Neck Surgery, Washington University School of Medicine in St Louis, St Louis, Missouri, USA
| | - Matthew R Naunheim
- Department of Otolaryngology-Head and Neck Surgery, Harvard Medical School, Boston, Massachusetts, USA
| | - Molly N Huston
- Department of Otolaryngology-Head and Neck Surgery, Washington University School of Medicine in St Louis, St Louis, Missouri, USA
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White SW, Bock JM, Blumin JH, Friedland DR, Adams JA, Tong L, Osinski K, Luo J. Analysis of socioeconomic factors in laryngology clinic utilization for treatment of dysphonia. Laryngoscope Investig Otolaryngol 2022; 7:202-209. [PMID: 35155799 PMCID: PMC8823153 DOI: 10.1002/lio2.715] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Revised: 10/08/2021] [Accepted: 11/16/2021] [Indexed: 01/10/2023] Open
Abstract
OBJECTIVE To evaluate the association between patient socioeconomic and demographic factors and tertiary care utilization for dysphonia in a localized metropolitan area of the American Midwest. METHODS Multivariate regression analysis was used to correlate patient demographics and population level data (e.g., age, gender, race, insurance, median income, education level) with tertiary laryngology utilization for dysphonia care at our institution between 2000 and 2019. Initial analyses characterized tertiary laryngology utilization rates for all regional ZIP codes and correlated these data with census information for household income and education. Dysphonia patient demographics were compared among populations cared for in our entire academic Otolaryngology department, our health system, and the regional population. RESULTS Among 1,365,021 patients in our health system, there were 7066 tertiary laryngology visits with a diagnosis of dysphonia. Dysphonia patients as compared to the overall health system were older (62.0 vs. 50.8 years), more likely to be female (63.7 vs. 50.2%) and more likely to have insurance (98.4 vs. 87.5%, all p < .001). Patient and population-level factors including insurance status, education, and black race showed positive correlation with laryngology utilization while median income did not. CONCLUSIONS AND RELEVANCE Insurance status, education level, and race correlated with utilization of tertiary laryngology services for the evaluation of dysphonia in our community, while median income did not. Black patients utilized tertiary laryngology care at higher rates compared to departmental and regional population utilization data. These results underscore important demographic and disease-specific factors that may affect utilization of subspecialty care in Otolaryngology. LEVEL OF EVIDENCE IV.
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Affiliation(s)
- Shane W. White
- Department of Otolaryngology and Communication SciencesMedical College of WisconsinMilwaukeeWisconsinUSA
| | - Jonathan M. Bock
- Department of Otolaryngology and Communication SciencesMedical College of WisconsinMilwaukeeWisconsinUSA
| | - Joel H. Blumin
- Department of Otolaryngology and Communication SciencesMedical College of WisconsinMilwaukeeWisconsinUSA
| | - David R. Friedland
- Department of Otolaryngology and Communication SciencesMedical College of WisconsinMilwaukeeWisconsinUSA
| | - Jazzmyne A. Adams
- Department of Otolaryngology and Communication SciencesMedical College of WisconsinMilwaukeeWisconsinUSA
| | - Ling Tong
- Department of Health Informatics and AdministrationUniversity of Wisconsin – MilwaukeeMilwaukeeWisconsinUSA
| | - Kristen Osinski
- Clinical and Translational Science InstituteMedical College of WisconsinMilwaukeeWisconsinUSA
| | - Jake Luo
- Department of Health Informatics and AdministrationUniversity of Wisconsin – MilwaukeeMilwaukeeWisconsinUSA
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Rodrigues Dias D, Santos M, Sousa F, Azevedo S, Sousa E Castro S, Freitas S, Almeida E Sousa C, Moreira da Silva Á. How do presbylarynx and presbycusis affect the Voice Handicap Index and the emotional status of the elderly? A prospective case-control study. J Laryngol Otol 2021; 135:1-6. [PMID: 34579801 DOI: 10.1017/s0022215121002528] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE To assess the influence of presbylarynx and presbycusis on Voice Handicap Index and emotional status. METHODS A case-control, prospective, observational, cross-sectional study was conducted of patients aged 65 years or older referred to an otorhinolaryngology department from January to September 2020. Presbycusis was assessed by pure tone and vocal audiometry. Each subject underwent fibre-optic videolaryngoscopy with stroboscopy, and presbylarynx was considered when two or more of the following endoscopic findings were identified: vocal fold bowing, prominence of vocal processes in abduction, and a spindle-shaped glottal gap. Each subject completed two questionnaires: Voice Handicap Index and Geriatric Depression Scale (short-form). RESULTS The studied population included 174 White European subjects, with a mean age of 73.99 years, of whom 22.8 per cent presented both presbylarynx and presbycusis. Multivariate linear regression revealed that only presence and severity of presbylarynx had an influence on Voice Handicap Index-30 scores. However, both spindle-shaped glottal gap and presbycusis influenced Geriatric Depression Scale scores. CONCLUSION Presbylarynx has a strong association with the impact of voice on quality of life. Presbylarynx and presbycusis seem to have a cumulative effect on emotional status.
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Affiliation(s)
- D Rodrigues Dias
- Department of Otolaryngology - Head and Neck Surgery, Centro Hospitalar Universitário do Porto, Instituto de Ciências Biomédicas Abel Salazar - Universidade do Porto, Porto, Portugal
| | - M Santos
- Department of Otolaryngology - Head and Neck Surgery, Centro Hospitalar Universitário do Porto, Instituto de Ciências Biomédicas Abel Salazar - Universidade do Porto, Porto, Portugal
| | - F Sousa
- Department of Otolaryngology - Head and Neck Surgery, Centro Hospitalar Universitário do Porto, Instituto de Ciências Biomédicas Abel Salazar - Universidade do Porto, Porto, Portugal
| | - S Azevedo
- Department of Otolaryngology - Head and Neck Surgery, Centro Hospitalar Universitário do Porto, Instituto de Ciências Biomédicas Abel Salazar - Universidade do Porto, Porto, Portugal
| | - S Sousa E Castro
- Department of Otolaryngology - Head and Neck Surgery, Centro Hospitalar Universitário do Porto, Instituto de Ciências Biomédicas Abel Salazar - Universidade do Porto, Porto, Portugal
| | - S Freitas
- Faculdade de Ciências da Saúde, Universidade Fernando Pessoa, Porto, Portugal
| | - C Almeida E Sousa
- Department of Otolaryngology - Head and Neck Surgery, Centro Hospitalar Universitário do Porto, Instituto de Ciências Biomédicas Abel Salazar - Universidade do Porto, Porto, Portugal
| | - Á Moreira da Silva
- Department of Intensive Care Unit, Centro Hospitalar Universitário do Porto, Instituto de Ciências Biomédicas Abel Salazar - Universidade do Porto, Porto, Portugal
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Deep connected attention (DCA) ResNet for robust voice pathology detection and classification. Biomed Signal Process Control 2021. [DOI: 10.1016/j.bspc.2021.102973] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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Chung TK, Hu A, Sardesai MG, Wilcox H, Jiang L, Meyer TK. Evaluating the Effect of Recurrent Respiratory Papillomatosis on Work Productivity. Ann Otol Rhinol Laryngol 2021; 131:709-714. [PMID: 34416839 DOI: 10.1177/00034894211040900] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
OBJECTIVE Patients with recurrent respiratory papillomatosis (RRP) have significant vocal dysfunction which affects their performance at work. This study aimed to evaluate voice-related work productivity before and after ablative treatment for RRP. METHODS This is a prospective case series conducted at 2 academic laryngology outpatient clinics. Adult employed patients with RRP completed the Work Productivity & Activity Impairment instrument (WPAI), Voice Handicap Index (VHI-10), WorkHoarse, Hospital Anxiety and Depression Scale (HADS), and a demographics questionnaire immediately before and 1 month after ablative treatment of papilloma. The primary outcome measure was the change in work productivity impairment domain of the WPAI, and changes in ratings before and after ablation were compared using a Wilcoxon Signed-Rank test. RESULTS The 32 participants (mean age 45, 84% male) had a median (interquartile range) voice-related work productivity impairment score of 48.8% (30.0) at baseline which was improved to 5.0% (10.0) at 1 month after surgical ablation of papillomata (difference 30.0% (30.0) improvement). For the secondary outcome measures, there were significant improvements in VHI-10 (P < .001), self-reported voice quality (P = .002), and Workhoarse (P = .001), but no significant change in HADS. CONCLUSION Patients with RRP experience significant voice-related work productivity impairment, and ablation of papillomata significantly improves work productivity.
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Affiliation(s)
- Thomas K Chung
- Department of Otolaryngology & Communication Enhancement, Boston Children's Hospital, Boston, MA, USA
| | - Amanda Hu
- Division of Otolaryngology - Head & Neck Surgery, Department of Surgery, University of British Columbia, Vancouver, BC, Canada
| | - Maya G Sardesai
- Department of Otolaryngology Head and Neck Surgery, University of Washington, Seattle, WA, USA
| | - Haley Wilcox
- Department of Otolaryngology Head and Neck Surgery, University of Washington, Seattle, WA, USA
| | - Lan Jiang
- Division of Clinical Pharmacology, Department of Medicine, Vanderbilt Medical Center, Nashville, TN, USA
| | - Tanya K Meyer
- Department of Otolaryngology Head and Neck Surgery, University of Washington, Seattle, WA, USA
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Pierce JL, Tanner K, Merrill RM, Shnowske L, Roy N. Acoustic Variability in the Healthy Female Voice Within and Across Days: How Much and Why? JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2021; 64:3015-3031. [PMID: 34269598 DOI: 10.1044/2021_jslhr-21-00018] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Purpose The aims of this study were (1) to quantify variability in voice production (as measured acoustically) within and across consecutive days in vocally healthy female speakers, (2) to identify which acoustic measures are sensitive to this variability, and (3) to identify participant characteristics related to such voice variability. Method Participants included 45 young women with normal voices who were stratified by age, specifically 18-23, 24-29, and 30-35 years. Following an initial acoustic and auditory-perceptual voice assessment, participants performed standardized field voice recordings 3 times daily across a 7-day period. Acoustic analyses involved 32 cepstral-, spectral-, and time-based measures of connected speech and sustained vowels. Relationships among acoustic data and select demographic, health, and lifestyle (i.e., participant-based) factors were also examined. Results Significant time-of-day effects were observed for acoustic analyses within speakers (p < .05), with voices generally being worse in the morning. No significant differences were observed across consecutive days. Variations in voice production were associated with several participant factors, including improved voice with increased voice use; self-perceived poor voice function, minimal or no alcohol consumption, and extroverted personality; and worse voice with regular or current menstruation, depression, and anxiety. Conclusions This acoustic study provides essential information regarding the nature and extent to which healthy voices vary throughout the day and week. Participant-based factors that were associated with improved voice over time included increased voice use, self-perceived poor voice function, minimal or no alcohol consumption, and extroverted personality. Factors associated with worse voice production over time included regular or current menstruation, and depression and anxiety.
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Affiliation(s)
- Jenny L Pierce
- Department of Surgery, The University of Utah, Salt Lake City
- Department of Communication Sciences and Disorders, The University of Utah, Salt Lake City
| | - Kristine Tanner
- Department of Communication Disorders, Brigham Young University, Provo, UT
| | - Ray M Merrill
- Department of Public Health, Brigham Young University, Provo, UT
| | - Lauren Shnowske
- Department of Communication Sciences and Disorders, The University of Utah, Salt Lake City
- Department of Communication Sciences and Disorders, University of Kentucky, Lexington
| | - Nelson Roy
- Department of Communication Sciences and Disorders, The University of Utah, Salt Lake City
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Schlegel P, Wong K, Aker M, Alhiyari Y, Long J. Objective Assessment of Porcine Voice Acoustics for Laryngeal Surgical Modeling. APPLIED SCIENCES (BASEL, SWITZERLAND) 2021; 11:4489. [PMID: 35495360 PMCID: PMC9047298] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Pigs have become important animal models in voice research. Several objective parameters exist to characterize the pig voice, but it is not clear which of them are sensitive to the impaired voice quality after laryngeal injury or surgery. In order to conduct meaningful voice research in pigs, it is critical to have standard functional voice outcome measures that can distinguish between normal and impaired voices. For this reason, we investigated 17 acoustic parameters before and early after surgery in three Yucatan mini pigs. Four parameters showed consistent changes between pre- and post-surgery recordings, mostly related to decreased spectral energy in higher frequencies after surgery. We recommend two of these, 50% spectral energy quartile (Q50) and Flux, for objective functional voice assessment of pigs undergoing laryngeal surgery. The long-term goal of this process is to enable quantitative voice outcome tracking of laryngeal surgical interventions in porcine models.
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Affiliation(s)
- Patrick Schlegel
- Department of Head & Neck Surgery, David Geffen School of Medicine, University of California Los Angeles (UCLA), Los Angeles, CA 90095, USA
| | - Kirsten Wong
- Department of Head & Neck Surgery, David Geffen School of Medicine, University of California Los Angeles (UCLA), Los Angeles, CA 90095, USA
| | - Mamdouh Aker
- Department of Head & Neck Surgery, David Geffen School of Medicine, University of California Los Angeles (UCLA), Los Angeles, CA 90095, USA
| | - Yazeed Alhiyari
- Department of Head & Neck Surgery, David Geffen School of Medicine, University of California Los Angeles (UCLA), Los Angeles, CA 90095, USA
| | - Jennifer Long
- Department of Head & Neck Surgery, David Geffen School of Medicine, University of California Los Angeles (UCLA), Los Angeles, CA 90095, USA
- Surgery and Perioperative Careline, Greater Los Angeles VAHS, Los Angeles, CA 90073, USA
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20
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Anand S, Bottalico P, Gray C. Vocal Fatigue in Prospective Vocal Professionals. J Voice 2021; 35:247-258. [DOI: 10.1016/j.jvoice.2019.08.015] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2019] [Revised: 08/15/2019] [Accepted: 08/16/2019] [Indexed: 11/30/2022]
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Kunin A, Sargheini N, Birkenbihl C, Moiseeva N, Fröhlich H, Golubnitschaja O. Voice perturbations under the stress overload in young individuals: phenotyping and suboptimal health as predictors for cascading pathologies. EPMA J 2020; 11:517-527. [PMID: 33200009 PMCID: PMC7658305 DOI: 10.1007/s13167-020-00229-8] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Accepted: 10/30/2020] [Indexed: 12/12/2022]
Abstract
Verbal communication is one of the most sophisticated human motor skills reflecting both-the mental and physical health of an individual. Voice parameters and quality changes are usually secondary towards functional and/or structural laryngological alterations under specific systemic processes, syndrome and pathologies. These include but are not restricted to dry mouth and Sicca syndromes, body dehydration, hormonal alterations linked to pubertal, menopausal, and andropausal status, respiratory disorders, gastrointestinal reflux, autoimmune diseases, endocrinologic disorders, underweight versus overweight and obesity, and diabetes mellitus. On the other hand, it is well-established that stress overload is a significant risk factor of cascading pathologies, including but not restricted to neurodegenerative and psychiatric disorders, diabetes mellitus, cardiovascular disease, stroke, and cancers. Our current study revealed voice perturbations under the stress overload as a potentially useful biomarker to identify individuals in suboptimal health conditions who might be strongly predisposed to associated pathologies. Contextually, extended surveys applied in the population might be useful to identify, for example, persons at high risk for respiratory complications under pandemic conditions such as COVID-19. Symptoms of dry mouth syndrome, disturbed microcirculation, altered sense regulation, shifted circadian rhythm, and low BMI were positively associated with voice perturbations under the stress overload. Their functional interrelationships and relevance for cascading associated pathologies are presented in the article. Automated analysis of voice recordings via artificial intelligence (AI) has a potential to derive digital biomarkers. Further, predictive machine learning models should be developed that allows for detecting a suboptimal health condition based on voice recordings, ideally in an automated manner using derived digital biomarkers. Follow-up stratification and monitoring of individuals in suboptimal health conditions are recommended using disease-specific cell-free nucleic acids (ccfDNA, ctDNA, mtDNA, miRNA) combined with metabolic patterns detected in body fluids. Application of the cost-effective targeted prevention within the phase of reversible health damage is recommended based on the individualised patient profiling.
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Affiliation(s)
- A. Kunin
- Departments of Maxillofacial Surgery and Hospital Dentistry, Voronezh N.N. Burdenko State Medical University, Voronezh, Russia
| | - N. Sargheini
- Center of Molecular Biotechnology, CEMBIO, Friedrich-Wilhelms-Universität Bonn, Bonn, Germany
| | - C. Birkenbihl
- Department of Bioinformatics, Fraunhofer Institute for Algorithms and Scientific Computing (SCAI), Schloss Birlinghoven, 53757 Sankt Augustin, Germany
- Bonn-Aachen International Center for IT, Rheinische Friedrich-Wilhelms-Universität Bonn, 53115 Bonn, Germany
| | - N. Moiseeva
- Departments of Maxillofacial Surgery and Hospital Dentistry, Voronezh N.N. Burdenko State Medical University, Voronezh, Russia
| | - Holger Fröhlich
- Department of Bioinformatics, Fraunhofer Institute for Algorithms and Scientific Computing (SCAI), Schloss Birlinghoven, 53757 Sankt Augustin, Germany
- Bonn-Aachen International Center for IT, Rheinische Friedrich-Wilhelms-Universität Bonn, 53115 Bonn, Germany
| | - Olga Golubnitschaja
- Predictive, Preventive and Personalised (3P) Medicine, Department of Radiation Oncology, University Hospital Bonn, Friedrich-Wilhelms-Universität Bonn, Bonn, Germany
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22
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Jordan VA, Cohen S, Lunos S, Horvath KJ, Sieger G, Misono S. Mental Health and Dysphonia: Which Comes First, and Does That Change Care Utilization? Laryngoscope 2020; 130:1243-1248. [PMID: 32034963 PMCID: PMC7269068 DOI: 10.1002/lary.28203] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2019] [Revised: 06/22/2019] [Accepted: 07/09/2019] [Indexed: 11/06/2022]
Abstract
OBJECTIVES Voice patients with voice disorders have a high prevalence of distress and mental health (MH) comorbidities, but it is unknown to what extent distress precedes or follows voice disorder diagnoses. Objectives were to compare 1) proportions of voice patients with MH diagnoses who received MH diagnoses first versus voice-related diagnoses first, 2) voice-related diagnoses and care utilization, and 3) time to specialty evaluation in each group. METHODS Patients with voice and MH diagnoses were identified using International Classification of Diseases, Ninth and Tenth Revisions codes in a large health system data repository from January 2005 through July 2017. Sociodemographics, comorbidities, MH- and voice-related diagnoses, and voice-related care utilization were analyzed using descriptive statistics and multivariable regression modeling. RESULTS Among the 11,419 patients with both voice and MH diagnoses, 63% (n = 7,251) received MH diagnoses prior to voice diagnoses, compared with 37% with a voice diagnosis first (P < 0.0001). The latter group received more specific voice-related diagnoses (e.g., laryngeal cancer [odds ratio (OR) 4.27], benign laryngeal neoplasm [OR 1.60]), and were more likely to ever see an otolaryngologist than those receiving MH diagnoses first (P < 0.0001). CONCLUSION Most patients with voice and MH diagnoses received a MH diagnosis first. Patients who receive MH diagnoses first appeared to have different voice-related healthcare compared to those who received voice diagnoses first. LEVEL OF EVIDENCE NA Laryngoscope, 130:1243-1248, 2020.
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Affiliation(s)
| | - Seth Cohen
- Duke Voice Care Center, Division of Otolaryngology – Head & Neck Surgery, Duke University Medical Center, Durham, NC
| | - Scott Lunos
- University of Minnesota, Clinical and Translational Science Institute, Biostatistical Design and Analysis Center
| | - Keith J. Horvath
- University of Minnesota, School of Public Health, Division of Epidemiology and Community Health
| | - Gretchen Sieger
- University of Minnesota, Clinical and Translational Science Institute, Best Practices Integrated Informatics Core
| | - Stephanie Misono
- University of Minnesota, Dept of Otolaryngology- Head and Neck Surgery
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Lenell C, Shao Q, Johnson AM. Identifying Concomitant Health Conditions in Individuals With Chronic Voice Problems. J Voice 2020; 35:810.e1-810.e5. [PMID: 32005625 DOI: 10.1016/j.jvoice.2020.01.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2019] [Accepted: 01/09/2020] [Indexed: 10/25/2022]
Abstract
OBJECTIVE Current clinical practice guidelines recommend a laryngoscopic referral for patients who present with hoarseness for longer than 28 days and earlier for patients with certain high-risk factors. The goal of this study was to identify additional possible concomitant health conditions in individuals with chronic (>28 days) hoarseness to improve early detection of chronic voice problems. METHODS Using data from the 2012 National Health Interview Survey, four health conditions were selected: Swallowing problems, respiratory problems, hormonal-cycle problems, and physical activity limitations. Multivariable logistic regressions controlling for age, gender, race, and smoking status, were used to calculate the odds ratios for the association of each of these four health conditions to chronic versus acute voice problems. RESULTS Of the 2,746 respondents who reported a voice disorder within the last year, 736 reported a voice problem lasting longer than 4 weeks in duration. After controlling for covariates, individuals reporting swallowing problems and physical activity limitations were more likely to report a chronic voice problem versus an acute voice problem, odds ratios with 95% confidence intervals of 1.983 (1.619, 2.430) and 1.716 (1.355, 2.173), respectively. No significant associations were found for respiratory or hormonal-cycle problems. CONCLUSION Individuals who present with both a voice problem and a swallowing problem or physical activity limitation may be at increased risk for developing a chronic voice problem. Therefore, these two health conditions should be included as high-risk factors when determining the escalation of care for a patient presenting with acute dysphonia.
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Affiliation(s)
- Charles Lenell
- Department of Communicative Sciences and Disorders, New York University, New York; Department of Otolaryngology - Head and Neck Surgery, New York University, School of Medicine, New York
| | - Qianhui Shao
- Department of Otolaryngology - Head and Neck Surgery, New York University, School of Medicine, New York
| | - Aaron M Johnson
- Department of Otolaryngology - Head and Neck Surgery, New York University, School of Medicine, New York.
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Low DM, Bentley KH, Ghosh SS. Automated assessment of psychiatric disorders using speech: A systematic review. Laryngoscope Investig Otolaryngol 2020; 5:96-116. [PMID: 32128436 PMCID: PMC7042657 DOI: 10.1002/lio2.354] [Citation(s) in RCA: 138] [Impact Index Per Article: 34.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2019] [Revised: 12/31/2019] [Accepted: 01/17/2020] [Indexed: 12/31/2022] Open
Abstract
OBJECTIVE There are many barriers to accessing mental health assessments including cost and stigma. Even when individuals receive professional care, assessments are intermittent and may be limited partly due to the episodic nature of psychiatric symptoms. Therefore, machine-learning technology using speech samples obtained in the clinic or remotely could one day be a biomarker to improve diagnosis and treatment. To date, reviews have only focused on using acoustic features from speech to detect depression and schizophrenia. Here, we present the first systematic review of studies using speech for automated assessments across a broader range of psychiatric disorders. METHODS We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. We included studies from the last 10 years using speech to identify the presence or severity of disorders within the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). For each study, we describe sample size, clinical evaluation method, speech-eliciting tasks, machine learning methodology, performance, and other relevant findings. RESULTS 1395 studies were screened of which 127 studies met the inclusion criteria. The majority of studies were on depression, schizophrenia, and bipolar disorder, and the remaining on post-traumatic stress disorder, anxiety disorders, and eating disorders. 63% of studies built machine learning predictive models, and the remaining 37% performed null-hypothesis testing only. We provide an online database with our search results and synthesize how acoustic features appear in each disorder. CONCLUSION Speech processing technology could aid mental health assessments, but there are many obstacles to overcome, especially the need for comprehensive transdiagnostic and longitudinal studies. Given the diverse types of data sets, feature extraction, computational methodologies, and evaluation criteria, we provide guidelines for both acquiring data and building machine learning models with a focus on testing hypotheses, open science, reproducibility, and generalizability. LEVEL OF EVIDENCE 3a.
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Affiliation(s)
- Daniel M. Low
- Program in Speech and Hearing Bioscience and Technology, Harvard Medical SchoolBostonMassachusetts
- Department of Brain and Cognitive SciencesMITCambridgeMassachusetts
| | - Kate H. Bentley
- Department of PsychiatryMassachusetts General Hospital/Harvard Medical SchoolBostonMassachusetts
- McGovern Institute for Brain Research, MITCambridgeMassachusetts
| | - Satrajit S. Ghosh
- Program in Speech and Hearing Bioscience and Technology, Harvard Medical SchoolBostonMassachusetts
- McGovern Institute for Brain Research, MITCambridgeMassachusetts
- Department of Otolaryngology, Head and Neck SurgeryHarvard Medical SchoolBostonMassachusetts
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25
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Age-related deficits in speech production: From phonological planning to motor implementation. Exp Gerontol 2019; 126:110695. [DOI: 10.1016/j.exger.2019.110695] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2019] [Revised: 08/15/2019] [Accepted: 08/17/2019] [Indexed: 11/18/2022]
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26
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Jordan VA, Lunos S, Sieger G, Horvath KJ, Cohen S, Misono S. Association of voice and mental health diagnoses with differences in voice-related care utilization. Laryngoscope 2019; 130:1496-1502. [PMID: 31508825 DOI: 10.1002/lary.28277] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2019] [Revised: 05/25/2019] [Accepted: 08/19/2019] [Indexed: 11/07/2022]
Abstract
OBJECTIVE To compare healthcare utilization in voice patients with versus without mental health (MH) diagnoses STUDY DESIGN: Retrospective study using electronic medical records from large regional healthcare system. METHODS We examined data on sociodemographic characteristics, comorbidities, voice-related diagnoses, and patterns of healthcare utilization (including medication use, tests and procedures, and outpatient visits). The study period spanned January 2005 through June 2017. RESULTS A total of 24,672 patients had at least one voice-related diagnosis. Of these, 11,483 (47%) also had at least one MH diagnosis compared to 14% in the overall repository (P < 0.0001). The most common voice-related diagnoses were nonspecific dysphonia (80%), acute laryngitis (30%), and vocal fold paresis/paralysis (7%). The 11,483 patients with both voice-related and MH diagnoses were more likely to have acute laryngitis and/or nonspecific dysphonia; less likely to have laryngeal cancer and/or paresis/paralysis; and more likely to have seen a primary care provider, to have received medications, and to have undergone radiology studies. In contrast, the 13,189 patients with only voice-related diagnoses had more overall voice-related visits, were more likely to have seen an otolaryngologist, and were more likely to have undergone a voice evaluation with a speech language pathologist. CONCLUSION Voice patients with MH diagnoses were less likely to see otolaryngology and more likely to have radiology studies than voice patients without MH diagnoses. Further study is warranted to characterize temporal sequences of care in this group of patients and determine whether these differences are attributable to referral patterns from primary care. LEVEL OF EVIDENCE 4 Laryngoscope, 130:1496-1502, 2020.
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Affiliation(s)
- Victoria A Jordan
- Department of Otolaryngology-Head and Neck Surgery, University of Minnesota, Minneapolis, Minnesota, U.S.A
| | - Scott Lunos
- Biostatistical Design and Analysis Center, Clinical and Translational Science Institute, University of Minnesota, Minneapolis, Minnesota, U.S.A
| | - Gretchen Sieger
- Best Practices Integrated Informatics Core, Clinical and Translational Science Institute, University of Minnesota, Minneapolis, Minnesota, U.S.A
| | - Keith J Horvath
- Department of Psychology at San Diego State University, San Diego, Minnesota, CA
| | - Seth Cohen
- Duke Voice Care Center, Division of Otolaryngology-Head & Neck Surgery, Duke University Medical Center, Durham, North Carolina, U.S.A
| | - Stephanie Misono
- Department of Otolaryngology-Head and Neck Surgery, University of Minnesota, Minneapolis, Minnesota, U.S.A
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Marmor S, Misono S. Treatment Receipt and Outcomes of Self-Reported Voice Problems in the US Population Aged ≥65 Years. OTO Open 2018; 2:2473974X18774023. [PMID: 30480215 PMCID: PMC6239145 DOI: 10.1177/2473974x18774023] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2018] [Revised: 03/06/2018] [Accepted: 04/10/2018] [Indexed: 11/16/2022] Open
Abstract
Objectives (1) Characterize the US population aged ≥65 years with self-reported voice problems, (2) describe voice treatment characteristics in this group, and (3) identify factors associated with self-reported voice improvement. Study Design Retrospective cohort study. Setting Population-based cross-sectional US national survey sample. Subjects and Methods We identified a cohort of adults aged ≥65 years from the 2012 National Health Interview Survey, a population-based US national survey. Descriptive and multivariable regression analyses were performed. Results The prevalence of self-reported voice problems in this cohort was 10%. Of those, 44% reported voice problems for >1 month. The strongest predictor of reporting voice improvement was receipt of voice treatment (odds ratio, 3.50; 95% confidence interval, 1.36-9.00), after adjusting for sex, age, race, education, and health status. Eleven percent reported voice treatment, which included 20% of those with moderate or worse voice problem severity. Female sex and worse health status were associated with reporting voice treatment. Among those with voice treatment, 38% reported “better,” 33% “same,” and 29% “worse” voice symptoms over the past year, compared to 17%, 67%, and 16%, respectively, among those without treatment. Health status influenced likelihood of reporting voice improvement but not universally. Conclusions We observed a significant self-reported burden of voice problems in the US population aged ≥65 years. Most are untreated and thus not well represented in the current literature. Vocal improvement was strongly associated with treatment. Further investigation is needed to clarify patient and treatment characteristics most associated with vocal improvement.
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Affiliation(s)
- Schelomo Marmor
- Department of Otolaryngology, University of Minnesota, Minneapolis, Minnesota, USA.,Department of Surgery, University of Minnesota, Minneapolis, Minnesota, USA
| | - Stephanie Misono
- Department of Otolaryngology, University of Minnesota, Minneapolis, Minnesota, USA
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Madill C, Warhurst S, McCabe P. The Stakeholder Model of voice research: Acknowledging barriers to human rights of all stakeholders in a communicative exchange. INTERNATIONAL JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2018; 20:63-66. [PMID: 29231072 DOI: 10.1080/17549507.2017.1400102] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
The act of communication is a complex, transient and often abstract phenomenon that involves many stakeholders, each of whom has their own perspective: the speaker, the listener, the observer and the researcher. Current research practices in voice disorder are frequently framed through a single lens - that of the researcher/clinician or their participant/patient. This single lens approach risks overlooking significant barriers to the basic human right of freedom of expression for those with a voice disorder as it omits consideration of the impact of voice disorder on the listener, and consideration of the wider impact of the voice in the occupational context. Recent research in the area of voice has developed a multiple lens and subsequent Stakeholder Model that acknowledges the experience and reality of multiple stakeholders viewing the same phenomenon, the voice. This research paradigm is built on Article 19 of the Universal Declaration of Human Rights as it considers the realities of all stakeholders in forming a deeper understanding of the causality, impact and aspects of communication disorder. The Stakeholder Model will be presented as a suggestion for future investigations of communication disorders more widely.
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Affiliation(s)
- Catherine Madill
- a Discipline of Speech Pathology, Faculty of Health Sciences , The University of Sydney , Sydney , Australia
| | - Samantha Warhurst
- a Discipline of Speech Pathology, Faculty of Health Sciences , The University of Sydney , Sydney , Australia
| | - Patricia McCabe
- a Discipline of Speech Pathology, Faculty of Health Sciences , The University of Sydney , Sydney , Australia
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29
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Hur K, Zhou S, Bertelsen C, Johns MM. Health disparities among adults with voice problems in the United States. Laryngoscope 2017; 128:915-920. [DOI: 10.1002/lary.26947] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2017] [Revised: 08/23/2017] [Accepted: 09/05/2017] [Indexed: 12/16/2022]
Affiliation(s)
- Kevin Hur
- USC Voice Center, Caruso Department of Otolaryngology-Head and Neck Surgery, Keck School of Medicine; University of Southern California; Los Angeles California U.S.A
| | - Sheng Zhou
- USC Voice Center, Caruso Department of Otolaryngology-Head and Neck Surgery, Keck School of Medicine; University of Southern California; Los Angeles California U.S.A
| | - Caitlin Bertelsen
- USC Voice Center, Caruso Department of Otolaryngology-Head and Neck Surgery, Keck School of Medicine; University of Southern California; Los Angeles California U.S.A
| | - Michael M. Johns
- USC Voice Center, Caruso Department of Otolaryngology-Head and Neck Surgery, Keck School of Medicine; University of Southern California; Los Angeles California U.S.A
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Bainbridge KE, Roy N, Losonczy KG, Hoffman HJ, Cohen SM. Voice disorders and associated risk markers among young adults in the United States. Laryngoscope 2016; 127:2093-2099. [PMID: 28008619 DOI: 10.1002/lary.26465] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2016] [Accepted: 11/10/2016] [Indexed: 11/09/2022]
Abstract
OBJECTIVES/HYPOTHESIS To examine the prevalence of voice disorders in young adults and identify sociodemographic factors, health conditions, and behaviors associated with voice disorder prevalence. STUDY DESIGN Cross-sectional analysis of data from the National Longitudinal Study of Adolescent to Adult Health. METHODS During home interviews, 14,794 young adults, aged 24 to 34 years, reported their health conditions and behaviors. Presence and duration of voice disorders were reported over the past 12 months. We computed overall and stratified prevalence estimates by age, gender, race/ethnicity, medical conditions, smoking, and alcohol use. Multiple logistic regression was used to identify independent risk factors for a voice disorder while accounting for the complex sample design. RESULTS Six percent of participants reported a voice disorder lasting at least 3 days. Females had 56% greater odds of voice disorders than males. Number of days drinking alcohol was associated with voice disorders, but number of smoking days was not. Conditions that increased the likelihood of voice disorders included hypertension (OR = 1.42 [95% confidence interval {CI}: 1.07-1.89]), tinnitus (OR = 1.53 [95% CI: 1.06-2.20]), and anxiety/panic disorder (OR = 1.26 [95% CI: 1.00-1.60]). Results were independent of gender, alcohol consumption, upper respiratory symptoms, and lower respiratory conditions including asthma, bronchitis/emphysema, and gastrointestinal symptoms (diarrhea/nausea/vomiting). CONCLUSIONS Voice disorders in young adulthood were associated with hypertension, tinnitus, and anxiety. Greater awareness of these relationships may facilitate voice evaluation among people who seek healthcare for these chronic conditions. LEVEL OF EVIDENCE 2b Laryngoscope, 127:2093-2099, 2017.
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Affiliation(s)
- Kathleen E Bainbridge
- Epidemiology and Statistics Program, Division of Scientific Programs, The University of Utah, Salt Lake City, Utah
| | - Nelson Roy
- National Institute on Deafness and Other Communication Disorders, Bethesda, Maryland; Department of Communication Sciences and Disorders, and Division of Otolaryngology-Head and Neck Surgery (Adjunct), The University of Utah, Salt Lake City, Utah
| | - Katalin G Losonczy
- Epidemiology and Statistics Program, Division of Scientific Programs, The University of Utah, Salt Lake City, Utah
| | - Howard J Hoffman
- Epidemiology and Statistics Program, Division of Scientific Programs, The University of Utah, Salt Lake City, Utah
| | - Seth M Cohen
- Duke Voice Care Center, Division of Head and Neck Surgery and Communication Sciences, Duke University Medical Center, Durham, North Carolina, U.S.A
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Misono S, Marmor S, Roy N, Mau T, Cohen SM. Factors Influencing Likelihood of Voice Therapy Attendance. Otolaryngol Head Neck Surg 2016; 156:518-524. [PMID: 27879417 DOI: 10.1177/0194599816679941] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Objective To identify factors associated with the likelihood of attending voice therapy among patients referred for it in the CHEER (Creating Healthcare Excellence through Education and Research) practice-based research network infrastructure. Study Design Prospectively enrolled cross-sectional study. Setting CHEER network of community and academic sites. Methods Data were collected on patient-reported demographics, voice-related diagnoses, voice-related handicap (Voice Handicap Index-10), likelihood of attending voice therapy (VT), and opinions on factors influencing likelihood of attending VT. The relationships between patient characteristics/opinions and likelihood of attending VT were investigated. Results A total of 170 patients with various voice-related diagnoses reported receiving a recommendation for VT. Of those, 85% indicated that they were likely to attend it, regardless of voice-related handicap severity. The most common factors influencing likelihood of VT attendance were insurance/copay, relief that it was not cancer, and travel. Those who were not likely to attend VT identified, as important factors, unclear potential improvement, not understanding the purpose of therapy, and concern that it would be too hard. In multivariate analysis, factors associated with greater likelihood of attending VT included shorter travel distance, age (40-59 years), and being seen in an academic practice. Conclusions Most patients reported plans to attend VT as recommended. Patients who intended to attend VT reported different considerations in their decision making from those who did not plan to attend. These findings may inform patient counseling and efforts to increase access to voice care.
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Affiliation(s)
- Stephanie Misono
- 1 Lions Voice Clinic, Department of Otolaryngology-Head and Neck Surgery, University of Minnesota, Minneapolis, Minnesota, USA
| | - Schelomo Marmor
- 1 Lions Voice Clinic, Department of Otolaryngology-Head and Neck Surgery, University of Minnesota, Minneapolis, Minnesota, USA.,2 Department of Surgery, University of Minnesota, Minneapolis, Minnesota, USA
| | - Nelson Roy
- 3 Department of Communication Sciences and Disorders, The University of Utah, Salt Lake City, Utah, USA
| | - Ted Mau
- 4 Clinical Center for Voice Care, Department of Otolaryngology-Head and Neck Surgery, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Seth M Cohen
- 5 Duke Voice Care Center, Division of Otolaryngology-Head and Neck Surgery, Duke University Medical Center, Durham, North Carolina, USA
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San Giorgi MRM, Aaltonen LM, Rihkanen H, Tjon Pian Gi REA, van der Laan BFAM, Hoekstra-Weebers JEHM, Dikkers FG. Quality of life of patients with recurrent respiratory papillomatosis. Laryngoscope 2016; 127:1826-1831. [DOI: 10.1002/lary.26413] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2016] [Revised: 09/28/2016] [Accepted: 10/10/2016] [Indexed: 12/30/2022]
Affiliation(s)
- Michel R. M. San Giorgi
- Department of Otorhinolaryngology/Head and Neck Surgery; University Medical Center Groningen, University of Groningen; Groningen the Netherlands
- Cancer Research Center; University of Groningen; Groningen the Netherlands
- Groningen Papilloma Studies; University of Groningen; the Netherlands
| | - Leena-Maija Aaltonen
- Department of Otorhinolaryngology-Head and Neck Surgery; University of Helsinki, Helsinki University Hospital; Helsinki Finland
| | - Heikki Rihkanen
- Department of Otorhinolaryngology-Head and Neck Surgery; University of Helsinki, Helsinki University Hospital; Helsinki Finland
| | - Robin E. A. Tjon Pian Gi
- Department of Otorhinolaryngology/Head and Neck Surgery; University Medical Center Groningen, University of Groningen; Groningen the Netherlands
- Cancer Research Center; University of Groningen; Groningen the Netherlands
- Groningen Papilloma Studies; University of Groningen; the Netherlands
| | - Bernard F. A. M. van der Laan
- Department of Otorhinolaryngology/Head and Neck Surgery; University Medical Center Groningen, University of Groningen; Groningen the Netherlands
- Cancer Research Center; University of Groningen; Groningen the Netherlands
| | | | - Frederik G. Dikkers
- Department of Otorhinolaryngology/Head and Neck Surgery; University Medical Center Groningen, University of Groningen; Groningen the Netherlands
- Cancer Research Center; University of Groningen; Groningen the Netherlands
- Groningen Papilloma Studies; University of Groningen; the Netherlands
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