Acoustic Voice Quality Index and Acoustic Breathiness Index: Analysis With Different Speech Material in the Brazilian Portuguese

Auditory-Perceptual Assessment and Acoustic Analysis of Gender Expression in the Voice

OBJECTIVE

Determine if acoustic measurements exist that are predictive of Auditory-Perceptual Assessment (APA) of gender expression in the voice of transgender, nonbinary, and cisgender Brazilian speakers by transgender, nonbinary, and cisgender judges, as well as speech-language pathologists in the area of voice studies.

METHODS

Cross-sectional study. Clips of speech (automatic speech and expressive reading of poetry) and sustained vowel emission of people of different genders were recorded and underwent APA for gender expression in the voice using a visual analog scale across 100 points, ranging from very masculine to very feminine. Sixteen acoustic measurements were extracted (noise, perturbation, spectral, and cepstral measurements). A descriptive and inferential analysis was performed using interclass coefficients of correlation and stepwise multiple linear regression, considering P < 0.05 for statistical significance.

RESULTS

Forty-seven people of different genders had their voices recorded. The perceived gender of these voices was judged by 236 people (65 speech-language pathologists, 101 cisgender people, and 70 transgender and nonbinary people). The perceptions and measurements that were predictive of gender perception in the voice differed according to the task (vowel or speech) and the group of judges. The predictive acoustic measurements that were common in all groups were: speech-median F0, harmonic-to-noise ratio (HNR), F0 standard deviation (F0sd), average width between F0 peaks, and spectral emphasis (Emph); vowels-median F0, HNR, F0sd, and average width between F0 peaks. Divergent measurements between groups were: speech-coefficient of variation of intensity, speech rate (Sr), minimum and maximum F0, jitter, and shimmer; vowels-coefficient of variation of intensity, Emph, Sr, and minimum and maximum F0.

CONCLUSION

There are acoustic measures that may predict APA; however, each group of judges considers different measures to evaluate gender, revealing an important influence of context on the evaluator in gender assessment through the voice.

Validation of the Acoustic Breathiness Index in Speakers of Finnish Language

Breathiness (perception of turbulence noise in the voice) is one of the major components of hoarseness in dysphonic voices. This study aims to validate a multiparameter analysis tool, the Acoustic Breathiness Index (ABI), for quantification of breathiness in the speaking voice, including both sustained vowels and continuous speech. One hundred and eight speakers with dysphonia (28 M, 80 F, mean age 50, SD 15.4 years) and 87 non-dysphonic controls (18 M, 69 F, mean age 42, SD 14 years) volunteered as participants. They read a standard text and sustained vowel /a:/. Acoustic recordings were made using a head-mounted microphone. Acoustic samples were evaluated perceptually by nine voice experts of different backgrounds (speech therapists, vocologists and laryngologists). Breathiness (B) from the GRBAS scale was rated. Headphones were used in the perceptual analysis. The dysphonic and non-dysphonic speakers differed significantly from each other in the auditory perceptual evaluation of breathiness. A significant difference was also found for ABI, which had a mean value of 2.26 (SD 1.15) for non-dysphonic and 3.07 (SD 1.75) for dysphonic speakers. ABI correlated strongly with B (rs = 0.823, p = 0.01). ABI's power to distinguish the groups was high (88.6%). The highest sensitivity and specificity of ABI (80%) was obtained at threshold value 2.68. ABI is a valid tool for differentiating breathiness in non-dysphonic and dysphonic speakers of Finnish.

The Performance of the Acoustic Voice Quality Index and Acoustic Breathiness Index in Synthesized Voices

OBJECTIVE

The aim of the present study was to investigate the performance of the Acoustic Voice Quality Index (AVQI) and the Acoustic Breathiness Index (ABI) in synthesized voice samples.

METHOD

The validity of the AVQI and ABI performances was analyzed in synthesized voice samples controlling the degree of predefined deviations for overall voice quality (G-scale) and breathiness (B-scale). A range of 26 synthesized voice samples with various severity degrees in G-scale with and without prominence of breathiness for male and female voices were created.

RESULTS

ABI received higher validity in the evaluation of breathiness than AVQI. Furthermore, ABI evaluated accurately breathiness degrees without considering roughness effects in voice samples and confirmed the findings of other studies with natural voices. Furthermore, ABI was more robust than AVQI in the evaluation of severe voice-disordered voice samples. Finally, AVQI represented moreover overall voice quality with an emphasis of breathiness evaluation and less roughness although roughness had a necessary component in overall voice quality evaluation.

CONCLUSION

AVQI and ABI are two robust measurements in the evaluation of voice quality. However, ABI received fewer errors than AVQI in the analyses of higher abnormalities in the voice signal. Disturbances of other subtypes of abnormal overall voice quality such as roughness were not demonstrated in the results of ABI.

Accuracy Analysis of the Multiparametric Acoustic Indices AVQI, ABI, and DSI for Speech-Language Pathologist Decision-Making

PURPOSE

To investigate the accuracy of the Acoustic Voice Quality Index (AVQI), the Acoustic Breathiness Index (ABI), and the Dysphonia Severity Index (DSI) for speech-language pathologist (SLP) decision-making in the evaluation of teachers' voice conditions.

METHODS

Cross-sectional observational study with a convenience sample composed of 21 teachers "fit" in carrying out their work activities as a teacher, and 21 considered "unfit" for the same. All teachers underwent a voice evaluation, carried out by a voice-specialized speech-language pathologist. Voice evaluation included the SLP's opinion on whether the teachers presented "fit" or "unfit" for work. The voice and speech samples used for the AVQI and ABI scores were the mid-three seconds of a sustained vowel /a/, and a spontaneous count from 1 to 10. The following parameters were used to extract the DSI score: mid-three seconds of a sustained vowel /a/, maximum phonation time of a sustained vowel /a/, ascending vocal glide on the vowel /a/ until reaching the highest pitch, and sustained vowel /a/ at the softest possible vocal intensity. The t-test was used to compare the difference between the AVQI and ABI indices. The Mann-Whitney test was used for the DSI index, with a confidence level of 95%. The receiver operating characteristic curve (ROC) was used for accuracy analysis.

RESULTS

There was a difference in AVQI values (P=0.008), ABI (P=0.014), and DSI (P=0.000) between groups. The cutoff points that revealed the highest specificity for the AVQI, ABI, and DSI respectively were 3.33 (sensitivity 57.1% and specificity 90.5%), 4 (sensitivity 57.1% and specificity 85.7%), and 1.62 (sensitivity 71.4% and specificity 90.5%).

CONCLUSION

The AVQI, ABI, and DSI are instruments that provide robust voice information and can help speech-language pathologists in their decision-making about whether teachers must or must not be restricted in their vocal activities at work.

Oropharyngeal geometry and acoustic parameters of voice in healthy and Parkinson's disease subjects

PURPOSE

to verify whether there are differences in acoustic measures and oropharyngeal geometry between healthy individuals and people with Parkinson's disease, according to age and sex, and to investigate whether there are correlations between oropharyngeal geometry measures in this population.

METHODS

40 individuals participated, 20 with a diagnosis of Parkinson's disease and 20 healthy individuals, matched by age, sex, and body mass index. Acoustic variables included fundamental frequency, jitter, shimmer, glottal-to-noise excitation ratio, noise, and mean intensity. Oropharyngeal geometry variables were measured with acoustic pharyngometry.

RESULTS

geometry variables were smaller in the group with Parkinson's disease, and older adults with Parkinson's disease had a smaller oropharyngeal junction area than healthy older adults. Regarding acoustic parameters of voice, fundamental frequency values were lower in males with Parkinson's disease, and jitter values ​​were higher in the non-elderly subjects with Parkinson's disease. There was a moderate positive correlation between oral cavity length and volume, pharyngeal cavity length and vocal tract length, and pharyngeal cavity volume and vocal tract volume.

CONCLUSION

individuals with Parkinson's disease had smaller glottal areas and oropharyngeal junction areas than healthy individuals. When distributed into sex and age groups, the fundamental frequency was lower in males with Parkinson's disease. There was a moderate positive correlation between oropharyngeal length and volume measures in the study sample.

The cepstral spectral index of dysphonia, the acoustic voice quality index and the acoustic breathiness index as novel multiparametric indices for acoustic assessment of voice quality

PURPOSE OF REVIEW

The objective assessment of voice quality using acoustic measures is an important pillar of voice diagnostics. This article reviews three recent acoustic measures and their clinical use in phoniatrics and laryngology.

RECENT FINDINGS

Two acoustic parameters, the cepstral spectral index of dysphonia (CSID) and the acoustic voice quality index (AVQI), have gained importance as validated multiparametric indices in the objective assessment of hoarseness because they include both continuous speech and sustained vowels. The acoustic breathiness index (ABI), another multiparametric index, assesses breathiness admixture during phonation and identifies it robustly, unaffected by other characteristics of dysphonia such as roughness.

SUMMARY

Acoustic measurements are useful diagnostic tools when used correctly with an appropriate recording system, consideration of environment and use of software programs. CSID, AVQI and ABI objectively improve the detection of voice quality abnormalities. In addition to their proven validity, their application is simple and their usability for clinicians is high.

Objective Analysis Of Voice Quality In Patients With Thyroid Pathology

OBJECTIVE

The goal of this study is to analyze the voice in patients with thyroid pathology through two objective indexes with great diagnostic accuracy. Overall vocal quality was evaluated with the Acoustic Voice Quality Index (AVQI v.03.01) and the breathy voice with the Acoustic Breathiness Index (ABI).

DESIGN

Observational case-control study.

SETTING

Hospital Universitario Nuestra Señora de Candelaria.

PARTICIPANTS

Fifty-eight subjects, 29 controls and 29 thyroidectomy candidates.

MAIN OUTCOME MEASURES

All participants with thyroid pathology completed the Spanish version of Voice Handicap Index-10. Also, patient complaints relating to possible laryngeal dysfunction were assessed through closed questions. A sustained vowel and three phonetically balanced sentences were recorded for each subject (118 samples). AVQI v.03.01 and ABI were assessed using the Praat program. Two raters perceptually evaluated each voice sample by using the Grade parameter of GRABS scale.

RESULTS

Acoustic analysis shows that 55.17% of subjects present values above the pathological threshold of the AVQI, and 58.62% above that of the ABI. Results of the Student's test comparisons of the AVQI and ABI values between the control group and the thyroid group show significantly higher values of AVQI (t_[56]  = -3.85, p < .001) and ABI (t_[54.39]  = -4.82, p < .001) in thyroidectomy candidates.

CONCLUSION

A mild decrease in vocal quality is part of the symptomatology presented by thyroidectomy candidates.

The Impact of Languages and Cultural Backgrounds on Voice Quality Analyses

OBJECTIVE

The aim of this study was to verify the influence of different cultural backgrounds and languages on the perception of voice quality. Another aim was to evaluate the correlation between clinical auditory-perceptual judgments with acoustic measurements, such as the acoustic voice quality index (AVQI) and the acoustic breathiness index (ABI), i.e., their effect on the concurrent validity.

METHODS

Brazilian and European participants rated 2 culturally and linguistically different datasets (i.e., 150 Brazilian Portuguese and 218 German voice sample sets), with each dataset containing concatenated voice samples of continuous speech and sustained phonation. The raters evaluated the vocal quality in terms of the overall voice quality and breathiness. Intra- and interrater reliabilities were also tested. The psychometric qualities of the AVQI and the ABI (concurrent validity and diagnostic accuracy) were analyzed, considering the perceptual ratings of Brazilian and European participants for each dataset.

RESULTS

Rater reliability decreased for nonnative participants when evaluating the nonnative dataset. Brazilian raters perceived the German voices as more severe, whereas German raters considered the overall voice quality of Brazilian voices as less severe than native raters. The concurrent validity of the AVQI and the ABI, i.e., the agreement with the auditory-perceptual evaluations, was high irrespectively of the group of participants. The diagnostic accuracy, which refers to the ability to identify a deviated voice, was higher, considering the perceptual evaluations of native listeners.

CONCLUSIONS

Brazilian raters classified voice quality as more deviated, and the Brazilian voice samples were measured to be less severe (a possible language characteristic). Further studies are necessary to verify whether there was a task or sample consequence or if adjustments to the AVQI and ABI equations are required for Brazilian Portuguese.

Voice Disorder Identification by using Hilbert-Huang Transform (HHT) and K Nearest Neighbor (KNN)

OBJECTIVES

Clinical evaluation of dysphonic voices involves a multidimensional approach, including a variety of instrumental and noninstrumental measures. Acoustic analyses provide an objective, noninvasive and intelligent measures of voice quality. Based on sound recordings, this paper proposes a new classification method of voice disorders with HHT and KNN.

METHODS

In this research, 12 features of each sample is calculated by HHT. Based on the algorithm of Linear Prediction Coefficient (LPCC), a sample can be characterized by 9 features. After each sample is expressed by 21 features, the classifier is constructed based on KNN. In addition, classifier based on KNN was further compared with random forest and extra trees classifiers in relation to their classification performance of voice disorder.

RESULTS

The experiment results revel that classifier based on KNN showed better performance than other two classifiers with accuracy rate of 93.3%, precision of 93%, recall rate of 95%, F1-score of 94% and the area of receiver operating characteristic curve is 0.976.

CONCLUSIONS

The method put forward in this paper can be effectively used to classify voice disorders.

A Case of Specificity: How Does the Acoustic Voice Quality Index Perform in Normophonic Subjects?

The acoustic voice quality index (AVQI) is a multiparametric tool based on six acoustic measurements to quantify overall voice quality in an objective manner, with the smoothed version of the cepstral peak prominence (CPPS) as its main contributor. In the last decade, many studies demonstrated its robust diagnostic accuracy and high sensitivity to voice changes across voice therapy in different languages. The aim of the present study was to provide information regarding AVQI’s and CPPS’s performance in normophonic non-treatment-seeking subjects, since these data are still scarce; concatenated voice samples, consisting of sustained vowel phonation and continuous speech, from 123 subjects (72 females, 51 males; between 20 and 60 years old) without vocally relevant complaints were evaluated by three raters and run in AVQI v.02.06. According to this auditory-perceptual evaluation, two cohorts were set up (normophonia versus slight perceived dysphonia). First, gender effects were investigated. Secondly, between-cohort differences in AVQI and CPPS were investigated. Thirdly, with the number of judges giving G = 1 to partition three sub-levels of slight hoarseness as an independent factor, differences in AVQI and CPPS across these sub-levels were investigated; for AVQI, no significant gender effect was found, whereas, for CPPS, significant trends were observed. For both AVQI and CPPS, no significant differences were found between normophonic and slightly dysphonic subjects. For AVQI, however, this difference did approach significance; these findings emphasize the need for a normative study with a greater sample size and subsequently greater statistical power to detect possible significant effects and differences.