Detecting Mild Phonotrauma in Daily Life

Overview

Journal Laryngoscope

Specialty Otorhinolaryngology

Date 2023 May 17

PMID 37194664

Authors

Jarrad H Van Stan

James Burns

Tiffiny Hron

Steven Zeitels

Bharat A Panuganti

Phillip R Purnell

Daryush D Mehta

Robert E Hillman

Hamzeh Ghasemzadeh

Affiliations

Soon will be listed here.

Abstract

Objective: The aim of this study was to gain quantitative insights into the role of daily voice use associated with mild phonotrauma via the Daily Phonotrauma Index (DPI), a measure derived from neck-surface acceleration magnitude (NSAM) and difference between the first two harmonic magnitudes (H1 - H2).

Methods: An ambulatory voice monitor recorded weeklong voice use for 151 female patients with phonotraumatic vocal hyperfunction (PVH) and 181 female vocally healthy controls. Three laryngologists rated phonotrauma severity from each patient's laryngoscopy. Mixed generalized linear models evaluated the accuracy, sensitivity, and specificity of the original DPI trained on all patients versus a mild DPI version trained on only patients rated with mild phonotrauma. Individual contribution of NSAM and H1 - H2 to each DPI model was also evaluated.

Results: Reliability across the laryngologists' phonotrauma ratings was moderate (Fleiss κ = 0.41). There were 70, 69, and 12 patients with mild, moderate, and severe phonotrauma, respectively. The mild DPI, compared to the original DPI, correctly classified more patients with mild phonotrauma (Cohen's d = 0.9) and less controls (d = -0.9) and did not change in overall accuracy. H1 - H2 contributed less to mild phonotrauma classification than NSAM for mild DPI.

Conclusions: Compared with the original DPI, the mild DPI exhibited higher sensitivity to mild phonotrauma and lower specificity to controls, but the same overall classification accuracy. These results support the mild DPI as a promising detector of early phonotrauma and that NSAM may be associated with early phonotrauma, and H1 - H2 may be a biomarker associated with vocal fold vibration in the presence of lesions.

Level Of Evidence: Level 4, case-control study Laryngoscope, 133:3094-3099, 2023.

Citing Articles

Effects of Recording Condition and Number of Monitored Days on the Discriminative Power of the Daily Phonotrauma Index.

Ghasemzadeh H, Hillman R, Van Stan J, Mehta D J Speech Lang Hear Res. 2025; 68(2):518-530.

PMID: 39804982 PMC: 11842042. DOI: 10.1044/2024_JSLHR-24-00237.

Consistency of the Signature of Phonotraumatic Vocal Hyperfunction Across Different Ambulatory Voice Measures.

Ghasemzadeh H, Hillman R, Mehta D J Speech Lang Hear Res. 2024; 67(7):1997-2020.

PMID: 38861454 PMC: 11253796. DOI: 10.1044/2024_JSLHR-23-00515.

Toward Generalizable Machine Learning Models in Speech, Language, and Hearing Sciences: Estimating Sample Size and Reducing Overfitting.

Ghasemzadeh H, Hillman R, Mehta D J Speech Lang Hear Res. 2024; 67(3):753-781.

PMID: 38386017 PMC: 11005022. DOI: 10.1044/2023_JSLHR-23-00273.

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