Human Communication Disorders, Universidade Federal de São Paulo -UNIFESP, São Paulo, Sao Paulo, Brazil; Centro de Estudos da Voz - CEV, São Paulo, Sao Paulo, Brazil.
Speech, Language and Hearing Sciences Department, Universidade Federal da Paraíba-UFPB, João Pessoa, Pariaba, Brazil.
J Voice. 2022 Jul;36(4):582.e1-582.e10. doi: 10.1016/j.jvoice.2020.08.010. Epub 2020 Aug 29.
To evaluate the Acoustic Voice Quality Index (AVQI) and its isolated acoustic measures accuracy in discriminating voices with different degrees of deviation.
Two hundred and fifty-eight voice samples (160 dysphonic; 98 vocally healthy). Information regarding acoustic analysis and overall degree of deviation (G) were considered. The acoustic analysis consisted of the AVQI total score and its isolated acoustic measures: smoothed cepstral peak prominence (CPPs); harmonic-to-noise ratio (HNR); shimmer local and dB (Shim, ShdB); the general slope of the spectrum (Slope) and tilt of the regression line through the spectrum (Tilt). The auditory-perceptual judgment was the median G score of five voice specialists (Cohen's = 0.605-0.773; Fleiss = 0.370). Quadratic discriminant analysis and accuracy, sensitivity, and specificity of performance measures were used to investigate the discriminatory power of these measures.
AVQI presented acceptable accuracy to differentiate voices with no vocal deviation and with vocal deviation (73.9%) and among the degrees of deviation (mild vs. moderate = 70.49%; mild vs. moderate = 71.39%; moderate vs. severe = 87.5%). No isolated acoustic measurement was consistent with differentiating voice quality among all degrees of deviation. A combination of five acoustic measures (CPPs, HNR, ShdB, Slope, Tilt) had the highest accuracy to differentiate between healthy and deviated voice (75.55%). Shimmer was more accurate to discriminate between voices with mild, moderate, and severe deviation; almost all isolated acoustic measurements were accurate to discriminate voices with moderate and severe deviation. The combination of acoustic measures presented higher accuracy (mild vs. moderate = 70.21%-74.29%; mild vs. moderate = 71.53%-76.11%; moderate vs. severe = 86%-95.50%).
AVQI is an accepted tool to discriminate among different degrees of vocal deviation, and more accurate between voices with moderate and severe deviations. Isolated acoustic measures perform better when discriminating voices with a higher degree of deviation. A combination of acoustic parameters, with the same weight, is more accurate to discriminate different degrees of deviation, however, not consistent.
评估嗓音障碍指数（AVQI）及其孤立声学测量指标在区分不同程度嗓音障碍中的准确性。
共纳入 258 例嗓音样本（160 例嗓音障碍；98 例嗓音正常）。分析包括声学分析和总体偏差度（G）。声学分析包括 AVQI 总分及其孤立声学测量指标：平滑后倒谱峰值突出度（CPPs）；谐波噪声比（HNR）；音域微扰（Shim）和微扰噪声比（dB）（Shim，ShdB）；频谱的总体斜率（Slope）和频谱回归线的斜率（Tilt）。听觉感知判断采用 5 位嗓音专家的 G 评分中位数（Cohen's 系数为 0.605-0.773；Fleiss 系数为 0.370）。采用二次判别分析和性能测量的准确性、敏感性和特异性，研究这些指标的判别能力。
AVQI 对无嗓音障碍和有嗓音障碍的嗓音（73.9%）以及不同程度嗓音障碍（轻度与中度之间为 70.49%；轻度与中度之间为 71.39%；中度与重度之间为 87.5%）的区分具有可接受的准确性。没有孤立的声学测量指标可以一致地区分所有程度的嗓音质量。5 项声学指标（CPPs、HNR、ShdB、Slope、Tilt）的组合对健康嗓音和异常嗓音的区分具有最高的准确性（75.55%）。Shimmer 对轻度、中度和重度嗓音障碍的区分更为准确；几乎所有孤立的声学测量指标都能准确地区分中度和重度嗓音障碍。声学指标组合的准确性更高（轻度与中度之间为 70.21%-74.29%；轻度与中度之间为 71.53%-76.11%；中度与重度之间为 86%-95.50%）。
AVQI 是一种可接受的工具，可用于区分不同程度的嗓音障碍，在区分中度和重度嗓音障碍时更为准确。孤立的声学测量指标在区分嗓音障碍程度较高时表现更好。具有相同权重的声学参数组合对区分不同程度的嗓音障碍更准确，但并不一致。
