GALP Qualifier Scale: Initial Considerations to Classify a Voice Problem

Voice Disorder Classifications: A Scoping Review - Part A

Voice is a complex and multidimensional phenomenon of interest to different disciplines. Divergent terminologies and, consequently, classification systems constitute, historically, a difficulty in this field of knowledge, which limits communication between professionals from different countries, backgrounds, and clinical experiences, and well as limiting clinical management and discussion of scientific research findings. This article aims to map and analyze the different diagnostic classifications in voice by describing the findings of a scoping review, consisting of both electronic and manual searches. The results are presented in two parts. In Part A of this article, we explore propositions for comprehensive diagnostic classifications, which involve theoretical frameworks for the constitution of each proposal. The included studies were classified as either articles with theoretical propositions, called G1, or articles using automated computerized classification systems called G2. A total of 44 articles were included: 27 in G1 and 17 in G2. In G1, we found studies from 1947 to 2021, most of which were from the USA, the authors having created theoretical propositions on the subject, considering mainly the etiology of vocal disorder. In G2, we found studies from 2009 onwards, emphasizing automated extraction of acoustic measurements and machine learning to create classification systems. G1 shows the propositions of classifications ranging from two to 11 main groups, each with possible subgroups. In G2, the classifications ranged from four to seven groups, showing preference to distinguish them by descriptions of laryngeal conditions. Conclusion: There is limited convergence between the different theoretical classifications, which is highlighted by the need to create different subgroups, or categories, to include different vocal disorders. The studies with a computerized approach reduce this variability to a certain extent; however, although promising, they should consider theoretical foundations in the proposition of classifications to be applicable to clinical setting.

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.