Pitch Strength as an Outcome Measure for Treatment of Dysphonia.
BACKGROUND
Measurement of treatment outcomes is critical for the spectrum of voice treatments (ie, surgical, behavioral, or pharmacological). Outcome measures typically include visual (eg, stroboscopic data), auditory (eg, Consensus Auditory-Perceptual Evaluation of Voice; Grade, Roughness, Breathiness, Asthenia, Strain), and objective correlates of vocal fold vibratory characteristics, such as acoustic signals (eg, harmonics-to-noise ratio, cepstral peak prominence) or patient self-reported questionnaires (eg, Voice Handicap Index, Voice-Related Quality of Life). Subjective measures often show high variability, whereas most acoustic measures of voice are only valid for signals where some degree of periodicity can be assumed. However, this assumption is often invalid for dysphonic voices where signal periodicity is suspect. Furthermore, many of these measures are not useful in isolation for diagnostic purposes.


OBJECTIVE
We evaluated a recently developed algorithm (Auditory Sawtooth Waveform Inspired Pitch Estimator-Prime [Auditory-SWIPE']) for estimating pitch and pitch strength for dysphonic voices. Whereas fundamental frequency is a physical attribute of a signal, pitch is its psychophysical correlate. As such, the perception of pitch can extend to most signals irrespective of their periodicity.


METHODS
Post hoc analyses were conducted for three groups of patients evaluated and treated for voice problems at a major voice center: (1) muscle tension dysphonia/functional dysphonia, (2) vocal fold mass(es), and (3) presbyphonia. All patients were recorded before and after surgical/behavioral treatment for voice disorders. Pitch and pitch strength for each speaker were computed with the Auditory-SWIPE' algorithm.


RESULTS
Comparison of pre- and posttreatment data provides support for pitch strength as a measure of treatment outcomes for dysphonic voices.
Department of Communicative Sciences and Disorders, Michigan State University, East Lansing, Michigan; Department of Communication Sciences and Disorders, University of Iowa, Iowa City, Iowa. Electronic address: lisa.m.kopf@gmail.com.
Lisa M
LM
Kopf
Department of Communicative Sciences and Disorders, Michigan State University, East Lansing, Michigan; Lakeshore Professional Voice Center, Lakeshore Ear, Nose, and Throat Center, St. Clair Shores, Michigan; Department of Otolaryngology, School of Medicine, Wayne State University, Detroit, Michigan.
Cristina
C
Jackson-Menaldi
Department of Communicative Sciences and Disorders, Michigan State University, East Lansing, Michigan; Lakeshore Professional Voice Center, Lakeshore Ear, Nose, and Throat Center, St. Clair Shores, Michigan; William Beaumont School of Medicine, Oakland University, Rochester, Michigan.
Adam D
AD
Rubin
Department of Communicative Sciences and Disorders, Michigan State University, East Lansing, Michigan; Lakeshore Professional Voice Center, Lakeshore Ear, Nose, and Throat Center, St. Clair Shores, Michigan.
Jean
J
Skeffington
Department of Communicative Sciences and Disorders, Michigan State University, East Lansing, Michigan.
Eric J
EJ
Hunter
Department of Communication Sciences and Disorders, University of South Florida, Tampa, Florida.
Mark D
MD
Skowronski
Department of Communicative Sciences and Disorders, Michigan State University, East Lansing, Michigan; Office of the Vice President for Instruction, University of Georgia, Athens, Georgia.
Rahul
R
Shrivastav
D000162:Acoustics; D000328:Adult; D000368:Aged; D000465:Algorithms; D055154:Dysphonia / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D013517:Otorhinolaryngologic Surgical Procedures; D010898:Pitch Perception; D011237:Predictive Value of Tests; D020127:Recovery of Function; D012189:Retrospective Studies; D012815:Signal Processing, Computer-Assisted; D013018:Sound Spectrography; D013061:Speech Acoustics; D013068:Speech Production Measurement / Q000379:methods*; D013997:Time Factors; D016896:Treatment Outcome; D014833:Voice Quality; D014834:Voice Training
Acoustic analysis; Fundamental frequency; Pitch; Pitch strength; Signal typing