title: Objective voice analysis in dysphonic patients: new data including nonlinear measurements.
abstract: OBJECTIVE
  This report describes a comparative study of objective voice evaluation using a multiparametric protocol including aerodynamic parameters and linear and nonlinear acoustic parameters recorded on an EVA(R) workstation and perceptual voice analysis by a jury.
  
  
  METHODS
  A total of 449 samples were retrospectively selected including 391 patients with pathological voices (308 women and 141 men) and 58 controls with normal voices (38 women and 20 men). A prospective complementary study concerning 43 female patients and 3 controls is presented.
  
  
  METHODS
  Objective measures included fundamental frequency (Fo), intensity, jitter, signal-to-noise ratio (SNR), Lyapunov coefficient (Lya), oral airflow (OAF), estimated subglottic pressure (ESGP), maximum phonatory time (MPT) and vocal range. A jury of 4 experienced listeners was instructed to classify voice samples (continuous speech) according to the G (overall dysphonia) component of the GRBAS score on a Visual Analogue Scale (VAS) secondarily transformed in a scale ranging from 0 for normal to 3 for severe dysphonia.
  
  
  RESULTS
  It was shown that a nonlinear combination of only 7 parameters in women (vocal range, Lya, ESGP, MPT, OAF, SNR, and Fo) and 6 parameters in men (vocal range, Lya, OAF, ESGP, Fo, SNR) allowed classification of 81% voice samples in the same grade as the jury in women and 84% in men. In the prospective study, 80.5% were correctly classified with the same set of objective measurements.
  
  
  CONCLUSIONS
  The relative importance of the different objective parameters in this type of discriminant analysis is dealt with. Special emphasis is placed on Lya.
authors.affiliation: Laboratoire d'Audio-Phonologie Expérimentale et Clinique, UPRES-EA 2668, Université de la Méditerranée, Fédération ORL CHU Timone, Marseille, France.
authors.forename: Ping
authors.initials: P
authors.lastname: Yu
authors.forename: Renaud
authors.initials: R
authors.lastname: Garrel
authors.forename: Richard
authors.initials: R
authors.lastname: Nicollas
authors.forename: Maurice
authors.initials: M
authors.lastname: Ouaknine
authors.forename: Antoine
authors.initials: A
authors.lastname: Giovanni
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017711:Nonlinear Dynamics; D010700:Phonetics; D012189:Retrospective Studies; D013068:Speech Production Measurement; D014832:Voice Disorders / Q000175:diagnosis* / Q000453:epidemiology*; D014833:Voice Quality