What do the voice-related parameters tell us? The multiparametric index scores, cepstral-based methods, patient-reported outcomes, and durational measurements

Purpose: This study aimed to identify how the acoustic parameters, patient-reported outcomes (PROs), and durational measurements differ based on perceptually rated dysphonia severity and to investigate their relationship with dysphonia severity.

Methods: One hundred seventy-nine subjects (males-78, females-101; mean ± SD age of 47.79 ± 14.05 years) with various etiology of dysphonia were included in this prospective cohort study. The G parameter of GRBAS was used to rate dysphonia severity. The Acoustic Voice Quality Index (AVQI v. 03.01), Acoustic Breathiness Index (ABI), and cepstral peak prominence-smoothed (CPPS) values for sustained vowel (CPPSsv) and connected speech (CPPScs) samples were obtained using the Praat software. The Voice Handicap Index-10 (VHI-10) and Voice-Related Quality of Life (V-RQOL) were used for PROs, and the maximum phonation time (MPT) and s/z ratio were measured as durational parameters.

Results: The acoustic parameters, including AVQI and ABI scores, and CPPSsv and CPPScs values significantly differed based on dysphonia severity, particularly in those with moderate (G₂) or severe dysphonia (G₃) compared to those with normal (G₀) and/or slightly deviated (G₁) voice. Among the PROs, VHI-10 scores significantly differed only between the groups G₁ and G₂ (p < 0.005) and the groups G₁ and G₃ (p < 0.005), whilst there were not any significant differences between the V-RQOL scores of all the compared groups. Significant differences were observed within the groups for MPT, but the s/z ratio significantly differed only between the groups G₁ and G₃. Correlation analysis revealed significant relationships between the G parameter of GRBAS and all measured variables (p < 0.001).

Conclusions: Particular attention should be paid to the AVQI and ABI scores, CPPsv and CPPcs values, VHI-10 scores, and MPT values since they provide valuable information for overall dysphonia severity.