Ambulatory monitoring of a vocal efficiency index to improve the clinical management of voice disorders

项目总结/摘要 在美国，声音障碍影响大约30%的成年人在他们生命中的某个时刻， 在任何时候都有大约2500万人遭受痛苦。声音障碍的影响是 影响深远，由于与工作有关的残疾，每年的社会负担高达135亿美元， 生产力损失和直接的医疗成本。患有声音障碍的人通常会遭受更严重的 说话时的声音努力和疲劳感，通常归因于无效的声音功能， 行为提高发声效率和减少发声努力以及相关的发声疲劳通常是发声的目标。 临床治疗范例。因此，发声效率是临床上非常期望的客观量度。 语音障碍的管理，特别是如果可以通过动态监测来跟踪语音健康 和发声行为的能力。 拟议的项目旨在制定一个流动发声效率指数， 声门下压和发声声压水平，以监测正在接受治疗的患者的发声努力， 声外伤性声带病变、非声外伤性发声功能亢进和单侧声带麻痹。 还将监测具有健康发声状态的个体作为性别、年龄和性别匹配的对照受试者。 职业/口头要求。采用柔性电路的创新可穿戴传感器技术 来自无线颈部表面加速度计和麦克风的同步数据，以跟踪 在现实世界中的发声效率。将该技术集成到智能手机平台中， 提示以提示受试者在视觉模拟量表上评定他们的发声努力水平。拟议工作 追求以下关键目标：（a）调查患者动态发声效率指数的临床有效性 与嗓音障碍和声音健康匹配的对照，和（B）评估动态发声效率 指标作为发声努力自我评价客观相关指标。这项工作的影响是巨大的，因为， 第一次，语音临床医生将能够在自然的，真实的环境中监测发声效率，以提高 预防、诊断和治疗嗓音障碍。

Project Summary/Abstract In the United States, voice disorders affect approximately 30% of the adult population at some point in their lives, with about 25 million individuals suffering at any given point in time. The impact of living with a voice disorder is far-reaching, and the societal burden reaches up to $13.5 billion dollars each year due to work-related disability, lost productivity, and direct healthcare costs. Individuals with voice disorders often suffer from heightened sensations of vocal effort and fatigue while speaking that are typically attributed to inefficient vocal function and behavior. Increasing vocal efficiency and decreasing vocal effort and associated vocal fatigue are often goals of clinical treatment paradigms. Thus, vocal efficiency is a highly desirable objective measure for the clinical management of voice disorders, particularly if it can be obtained via ambulatory monitoring to track vocal health and vocal behavior in a patient’s natural environment. The proposed project seeks to develop an index of ambulatory vocal efficiency that integrates estimates of subglottal pressure and vocal sound pressure level to monitor the vocal effort of patients being treated for phonotraumatic vocal cord lesions, non-phonotraumatic vocal hyperfunction, and unilateral vocal fold paralysis. Individuals with healthy vocal status will also be monitored as control subjects matched for sex, age, and occupational/vocal demands. An innovative wearable sensor technology using flexible circuits obtains synchronized data from a wireless neck-surface accelerometer and microphone to track the index of ambulatory vocal efficiency in real-world settings. Integrating the technology into a smartphone platform enables periodic prompting to prompt subjects to rate their level of vocal effort on a visual analog scale. The proposed work pursues critical goals of (a) investigating the clinical validity of the ambulatory vocal efficiency index in patients with voice disorders and vocally healthy matched controls and (b) assessing the ambulatory vocal efficiency index as an objective correlate of self-ratings of vocal effort. The impact of this work is significant because, for the first time, voice clinicians will be able to monitor vocal efficiency in naturalistic, real-world settings to improve the prevention, diagnosis, and treatment of voice disorders.