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

项目摘要/摘要 在美国，大约30%的成年人口在一生中的某个时候会受到嗓音障碍的影响， 在任何给定的时间点，大约有2500万人遭受痛苦。与发音障碍一起生活的影响是 影响深远，每年因工作残疾造成的社会负担高达135亿美元， 生产力损失，以及直接的医疗成本。患有发音障碍的人通常患有高度发音 说话时的发声吃力和疲劳感，通常归因于发声功能低下和 行为。提高发声效率、减少发声努力和相关的发声疲劳通常是 临床治疗范例。因此，发声效率是临床非常理想的客观指标。 管理发声障碍，特别是如果可以通过动态监测来跟踪发声健康的话 以及患者自然环境中的发声行为。 拟议的项目寻求开发一种门诊发声效率的指数，该指数综合了 声门下压力和声压水平监测接受治疗患者的发声努力 声带损伤、非声带损伤、声带功能亢进和单侧声带瘫痪。 具有健康发声状态的个体也将被监测为性别、年龄和 职业/发声要求。一种使用灵活电路的创新可穿戴传感器技术获得 来自无线颈面加速度计和麦克风的同步数据，以跟踪步行指数 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，可以定期 提示受试者在视觉模拟尺度上对他们的发声努力程度进行评级。拟议中的工作 追求以下关键目标：(A)调查患者非卧床发声效率指数的临床有效性 有发声障碍和发声健康的配对对照组和(B)评估非卧床发声效率 指数作为发声努力自我评分的客观相关性。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 嗓音障碍的预防、诊断和治疗。

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.