title: Quantifying the cepstral peak prominence, a measure of dysphonia.
abstract: OBJECTIVE
  The purpose of this study is to establish normative values for the smoothed cepstral peak prominence (CPPS) and its sensitivity and specificity as a measure of dysphonia.
  
  
  METHODS
  Prospective cohort study.
  
  
  METHODS
  Voice samples of running speech were obtained from 835 patients and 50 volunteers. Eight laryngologists and four speech-language pathologists performed perceptual ratings of the voice samples on the degree of dysphonia/normality using an analog scale. The mean of their perceptual ratings was used as the gold standard for the detection of the presence or absence of dysphonia. CPPS was measured using the CPPS algorithm of Hillenbrand, and the cut-off value for positivity that has the highest sensitivity and specificity for discriminating between normal and severely dysphonia voices was determined based on ROC-curve analysis.
  
  
  RESULTS
  The cut-off value for normal for CPPS was set at 4.0 or higher, which gave a sensitivity of 92.4%, a specificity of 79%, a positive predictive value of 82.5%, and a negative predictive value of 90.8%. The area under the receiver operating characteristic (ROC) curve was 0.937 (P < 0.05).
  
  
  CONCLUSIONS
  CPPS is a good measure of dysphonia, with the normal value of CPPS (Hillenbrand algorithm) of a running speech sample being defined as a value of 4.0 or higher.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Drexel University College of Medicine, Philadelphia, Pennsylvania. Electronic address: phillyvoicemd@aol.com.
authors.forename: Yolanda D
authors.initials: YD
authors.lastname: Heman-Ackah
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Drexel University College of Medicine, Philadelphia, Pennsylvania.
authors.forename: Robert T
authors.initials: RT
authors.lastname: Sataloff
authors.affiliation: Ziekenhuis Oost Limburg, Genk and University Hospitals, Leuven, Belgium.
authors.forename: Griet
authors.initials: G
authors.lastname: Laureyns
authors.affiliation: Department of Mathematics, St. Joseph's University, Philadelphia, Pennsylvania.
authors.forename: Deborah
authors.initials: D
authors.lastname: Lurie
authors.affiliation: Department of Otolaryngology, Head and Neck Surgery, University of Minnesota, Minneapolis, Minnesota.
authors.forename: Deirdre D
authors.initials: DD
authors.lastname: Michael
authors.affiliation: Department of Communication Sciences and Disorders, Temple University, Philadelphia, Pennsylvania.
authors.forename: Reinhardt
authors.initials: R
authors.lastname: Heuer
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, University of Michigan, Ann Arbor, Michigan.
authors.forename: Adam
authors.initials: A
authors.lastname: Rubin
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, US Air Force.
authors.forename: Robert
authors.initials: R
authors.lastname: Eller
authors.affiliation: Division of Otolaryngology, University of Louisville School of Medicine, Louisville, Kentucky.
authors.forename: Swapna
authors.initials: S
authors.lastname: Chandran
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, University of Colorado-Denver, Denver, Colorado.
authors.forename: Mona
authors.initials: M
authors.lastname: Abaza
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Drexel University College of Medicine, Philadelphia, Pennsylvania.
authors.forename: Karen
authors.initials: K
authors.lastname: Lyons
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Drexel University College of Medicine, Philadelphia, Pennsylvania.
authors.forename: Venu
authors.initials: V
authors.lastname: Divi
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University, Baltimore, Maryland.
authors.forename: Joanna
authors.initials: J
authors.lastname: Lott
authors.affiliation: Department of Communication Disorders, Texas State University, San Marcos, Texas.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Johnson
authors.affiliation: Department of Speech Pathology and Audiology, Western Michigan University, Kalamazoo, Michigan.
authors.forename: James
authors.initials: J
authors.lastname: Hillenbrand
mesh_terms: D000465:Algorithms; D019540:Area Under Curve; D016022:Case-Control Studies; D055154:Dysphonia / Q000175:diagnosis* / Q000503:physiopathology; D005260:Female; D006801:Humans; D007600:Judgment; D008297:Male; D015588:Observer Variation; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012372:ROC Curve; D015203:Reproducibility of Results; D012720:Severity of Illness Index; D012815:Signal Processing, Computer-Assisted; D013061:Speech Acoustics; D013067:Speech Perception; D013068:Speech Production Measurement; D014481:United States; D014833:Voice Quality
keywords: CPP; CPPS; Cepstral peak prominence; Dysphonia; Hoarseness; Objective voice measurement; Voice measure