Do We Get What We Need from Clinical Acoustic Voice Measurements?

Featured Application This article discusses the current state of the art and knowledge gaps in clinical acoustic analysis of voice quality and proposes future directions. Instrumental acoustic measurements of the human voice have enormous potential to objectively describe pathology and, thereby, to assist clinical treatment decisions. Despite the increasing application and accessibility of technical knowledge and equipment, recent research has highlighted a lack of understanding of physiologic, speech/language-, and culture-related influencing factors. This article presents a critical review of the current state of the art in the clinical application of instrumental acoustic voice quality measurements and points out future directions for improving its applications and dissemination in less privileged populations. The main barriers to this research relate to (a) standardization and reporting of acoustic analysis techniques; (b) understanding of the relation between perceptual and instrumental acoustic results; (c) the necessity to account for natural speech-related covariables, such as differences in speaking voice sound pressure level (SPL) and fundamental frequency f(0); (d) the need for a much larger database to understand normal variability within and between voice-disordered and vocally healthy individuals related to age, training, and physiologic factors; and (e) affordable equipment, including mobile communication devices, accessible in various settings. This calls for further research into technical developments and optimal assessment procedures for pathology-specific patient groups.