Ambulatory monitoring of vocal function to improve voice disorder assessment

动态监测声音功能以改善声音障碍评估

• 批准号: 8101468
• 负责人: Robert E Hillman
• 金额: $ 26.36万
• 依托单位: MASSACHUSETTS GENERAL HOSPITAL
• 依托单位国家: 美国
• 财政年份: 2011
• 资助国家: 美国
• 起止时间: 2011-04-06 至 2012-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8101468
• 关键词: Address; Adoption; Affect; Aftercare; Age; Algorithms; Ambulatory Monitoring; Architecture; Area; Behavior; Behavior Therapy; Biofeedback; Biological Models; Calibration; Charge; Chronic; Clinical; Clinical Protocols; Clinical assessments; Code; Computer software; Custom; Data; Data Collection; Development; Devices; Diagnosis; Diagnostic; Disease; Dose; Electrocardiogram; Frequencies; Funding; Future; Gap Junctions; Generations; Goals; Hour; Individual; Intervention; Measures; Memory; Methods; Mission; Modeling; Monitor; NIH Program Announcements; National Institute on Deafness and Other Communication Disorders; Neck; Patients; Pattern; Phase; Phased Innovation Awards; Phonation; Physiologic pulse; Physiological; Population; Process; Protocols documentation; Reproduction; Research Project Grants; Risk; Sampling; Signal Transduction; Speech; Stratification; System; Technology; Telephone; Testing; Time; United States; Vision; Voice; Voice Disorders; Work; base; clinical practice; cost; cost effective; data acquisition; design; digital; dosage; improved; miniaturize; pressure; prototype; response; sensor; software systems; sound; tool; voice therapy

DESCRIPTION (provided by applicant): Voice disorders affect approximately 6.6% of the working-age population in the United States. Many common voice disorders are chronic or recurring conditions that are likely to result from faulty and/or abusive patterns of vocal behavior referred to generically as vocal hyperfunction. Such behaviorally based disorders can be difficult to accurately assess in the clinical setting and could potentially be much better characterized by long-term ambulatory monitoring of vocal function as individuals engage in their typical daily activities. Devices that use a neck-placed miniature accelerometer (ACC) as a phonation sensor have shown the best potential for unobtrusive long-term monitoring of vocal function. The adoption, however, of this technology into clinical practice has been quite limited because of: 1) technical limitations of current devices, measures, and analysis algorithms; 2) the relatively high cost of commercially-available systems; and 3) the lack of statistically robust studies to determine the true diagnostic capabilities of ACC-based measures. The overall goal of the proposed project (in response to PAR-09-057) is to develop ACC-based ambulatory monitoring of vocal function into a valid, reliable, and cost-effective clinical tool that can be used to accurately identify and differentiate patterns of voice use that are associated with hyperfunctional voice disorders. Achieving this goal will: 1) greatly improve clinical assessment of these commonly-occurring types of voice disorders, 2) enable voice therapy to more accurately target specific hyperfunctional behaviors for individual patients, and 3) provide the basis for future efforts to develop ambulatory biofeedback approaches that have the potential to facilitate more efficient and effective behavioral treatment of these disorders. In the R21 phase of this project we will develop and validate a new, versatile, and cost-effective system for ambulatory voice monitoring that uses a neck-placed miniature ACC as the phonation sensor and a mobile personal digital device (e.g., a smartphone) as the data acquisition platform. An effort will be made to facilitate the continued availability of this technology for clinical use and development by designing system software and basic interface circuitry that is largely compatible with new generations of personal digital device architecture. The R33 phase of the project will focus on using the new ambulatory monitoring system to collect data from a large, statistically robust sample of patients with hyperfunctional voice disorders (before and after treatment) and matched controls. These data will be subjected to three types of analysis approaches in an effort to identify the best set of measures for differentiating among hyperfunctional and normal patterns of vocal behavior: 1) previously-developed ambulatory measures of vocal function that include vocal dosage; 2) measures based on estimates of glottal airflow that are extracted from the ACC signal using a new vocal system model, and 3) measures based on methods that have been used successfully in analyzing long-term recordings of other physiologic signals (e.g., electrocardiograms) for risk stratification of patients. PUBLIC HEALTH RELEVANCE: The current proposal seeks to address the main goal set forth in Program Announcement PAR-09-057 from the National Institute on Deafness and Other Communication Disorders (NIDCD), which is "...to develop new or enhanced diagnostic, intervention and treatment paradigms with potential for widespread, cost-effective application in the NIDCD mission areas...", which include voice and speech. This goal will be accomplished in the current project by developing ambulatory voice monitoring into a valid, reliable, and cost-effective clinical tool that can be used to improve the diagnosis and treatment of voice disorders.

描述(由申请人提供)：在美国，大约6.6%的劳动年龄人口患有嗓音障碍。许多常见的嗓音障碍是慢性或复发性疾病，很可能是由发声行为的缺陷和/或辱骂模式引起的，统称为发声功能亢进。这种基于行为的障碍可能很难在临床环境中准确评估，而且在个人进行典型的日常活动时，通过长期动态监测发声功能可能会更好。使用颈部放置的微型加速度计(ACC)作为发声传感器的设备已经显示出对发声功能进行不显眼的长期监测的最好潜力。然而，由于以下原因，这项技术在临床实践中的采用相当有限：1)当前设备、测量和分析算法的技术限制；2)商用系统的相对较高的成本；以及3)缺乏统计上可靠的研究来确定基于ACC的测量的真正诊断能力。拟议项目的总体目标(响应PAR-09-057)是将基于ACC的动态发声功能监测发展成为一种有效、可靠和经济高效的临床工具，可用于准确识别和区分与功能亢进性发声障碍相关的发声使用模式。实现这一目标将：1)大大改进对这些常见类型的发声障碍的临床评估；2)使发声疗法能够更准确地针对个别患者的特定功能亢进行为；以及3)为未来开发可促进这些疾病的更有效和更有效的行为治疗的非卧床生物反馈方法提供基础。在这个项目的R21阶段，我们将开发和验证一种新的、多功能的、具有成本效益的动态语音监控系统，该系统使用颈部放置的微型ACC作为语音传感器，并使用移动个人数字设备(如智能手机)作为数据采集平台。将努力通过设计与新一代个人数字设备架构基本兼容的系统软件和基本接口电路，促进这项技术继续用于临床和开发。该项目的R33阶段将侧重于使用新的动态监测系统从大量统计稳健的样本中收集数据，这些样本包括(治疗前和治疗后)功能性发音障碍患者和匹配的对照组。这些数据将受到三种类型的分析方法的影响，以努力确定用于区分发声行为的功能亢进和正常模式的最佳测量集：1)先前开发的包括发声剂量的发声功能测量；2)基于使用新的发声系统模型从ACC信号中提取的声门气流的估计的测量；以及3)基于已被成功用于分析其他生理信号(例如，心电图)的长期记录的方法的测量，用于患者的风险分层。 公共卫生相关性：目前的提案旨在解决国家失聪和其他沟通障碍研究所(NIDCD)在项目公告PAR-09-057中提出的主要目标，即“……开发新的或增强的诊断、干预和治疗范例，具有在NIDCD任务区广泛、经济有效地应用的潜力……”，其中包括语音和语言。这一目标将在目前的项目中实现，方法是将动态语音监测发展成为一种有效、可靠和具有成本效益的临床工具，可用于改善语音障碍的诊断和治疗。

项目成果

Validation of an Algorithm for Semi-automated Estimation of Voice Relative Fundamental Frequency.

• DOI: 10.1177/0003489417728088
• 发表时间: 2017-10
• 期刊: The Annals of otology, rhinology, and laryngology
• 作者: Lien YS;Heller Murray ES;Calabrese CR;Michener CM;Van Stan JH;Mehta DD;Hillman RE;Noordzij JP;Stepp CE
• 通讯作者: Stepp CE

Modeling the effects of a posterior glottal opening on vocal fold dynamics with implications for vocal hyperfunction.

模拟后声门开口对声带动力学的影响及其对发声机能亢进的影响。

• DOI: 10.1121/1.4901714
• 发表时间: 2014
• 期刊: The Journal of the Acoustical Society of America
• 作者: Zañartu,Matías;Galindo,GabrielE;Erath,ByronD;Peterson,SeanD;Wodicka,GeorgeR;Hillman,RobertE
• 通讯作者: Hillman,RobertE

Evaluation of Glottal Inverse Filtering Algorithms Using a Physiologically Based Articulatory Speech Synthesizer.

使用基于生理学的发音语音合成器评估声门逆滤波算法。

• DOI: 10.1109/taslp.2017.2714839
• 发表时间: 2017
• 期刊: IEEE/ACM transactions on audio, speech, and language processing
• 作者: Chien,Yu-Ren;Mehta,DaryushD;Guðnason,Jón;Zañartu,Matías;Quatieri,ThomasF
• 通讯作者: Quatieri,ThomasF