Background: Studies have used questionnaires of dysphonic symptoms to screen voice disorders. This study investigated whether the differential presentation of demographic and symptomatic features can be applied to computerized classification. Methods: We recruited 100 patients with glottic neoplasm, 508 with phonotraumatic lesions, and 153 with unilateral vocal palsy. Statistical analyses revealed significantly different distributions of demographic and symptomatic variables. Machine learning algorithms, including decision tree, linear discriminant analysis, K-nearest neighbors, support vector machine, and artificial neural network, were applied to classify voice disorders. Results: The results showed that demographic features were more effective for detecting neoplastic and phonotraumatic lesions, whereas symptoms were useful for detecting vocal palsy. When combining demographic and symptomatic variables, the artificial neural network achieved the highest accuracy of 83 ± 1.58%, whereas the accuracy achieved by other algorithms ranged from 74 to 82.6%. Decision tree analyses revealed that sex, age, smoking status, sudden onset of dysphonia, and 10-item voice handicap index scores were significant characteristics for classification. Conclusion: This study demonstrated a significant difference in demographic and symptomatic features between glottic neoplasm, phonotraumatic lesions, and vocal palsy. These features may facilitate automatic classification of voice disorders through machine learning algorithms.

1.
Best
SR
,
Fakhry
C
.
The prevalence, diagnosis, and management of voice disorders in a National Ambulatory Medical Care Survey (NAMCS) cohort
.
Laryngoscope
.
2011
Jan
;
121
(
1
):
150
7
.
[PubMed]
0023-852X
2.
Cohen
SM
,
Kim
J
,
Roy
N
,
Asche
C
,
Courey
M
.
Prevalence and causes of dysphonia in a large treatment-seeking population
.
Laryngoscope
.
2012
Feb
;
122
(
2
):
343
8
.
[PubMed]
0023-852X
3.
Cohen
SM
,
Dupont
WD
,
Courey
MS
.
Quality-of-life impact of non-neoplastic voice disorders: a meta-analysis
.
Ann Otol Rhinol Laryngol
.
2006
Feb
;
115
(
2
):
128
34
.
[PubMed]
0003-4894
4.
Merrill
RM
,
Roy
N
,
Lowe
J
.
Voice-related symptoms and their effects on quality of life
.
Ann Otol Rhinol Laryngol
.
2013
Jun
;
122
(
6
):
404
11
.
[PubMed]
0003-4894
5.
Titze
IR
,
Lemke
J
,
Montequin
D
.
Populations in the U.S. workforce who rely on voice as a primary tool of trade: a preliminary report
.
J Voice
.
1997
Sep
;
11
(
3
):
254
9
.
[PubMed]
0892-1997
6.
Williams
NR
.
Occupational groups at risk of voice disorders: a review of the literature
.
Occup Med (Lond)
.
2003
Oct
;
53
(
7
):
456
60
.
[PubMed]
0962-7480
7.
Coyle
SM
,
Weinrich
BD
,
Stemple
JC
.
Shifts in relative prevalence of laryngeal pathology in a treatment-seeking population
.
J Voice
.
2001
Sep
;
15
(
3
):
424
40
.
[PubMed]
0892-1997
8.
Preciado-López
J
,
Pérez-Fernández
C
,
Calzada-Uriondo
M
,
Preciado-Ruiz
P
.
Epidemiological study of voice disorders among teaching professionals of La Rioja, Spain
.
J Voice
.
2008
Jul
;
22
(
4
):
489
508
.
[PubMed]
0892-1997
9.
Van Houtte
E
,
Van Lierde
K
,
D’Haeseleer
E
,
Claeys
S
.
The prevalence of laryngeal pathology in a treatment-seeking population with dysphonia
.
Laryngoscope
.
2010
Feb
;
120
(
2
):
306
12
.
[PubMed]
1531-4995
10.
Bermúdez de Alvear
RM
,
Barón
FJ
,
Martínez-Arquero
AG
.
School teachers’ vocal use, risk factors, and voice disorder prevalence: guidelines to detect teachers with current voice problems
.
Folia Phoniatr Logop
.
2011
;
63
(
4
):
209
15
.
[PubMed]
1021-7762
11.
Stemple
JC
,
Roy
N
,
Klaben
BK
.
Clinical voice pathology theory and management
.
Plural Publishing
;
2014
.
12.
Hashibe
M
,
Brennan
P
,
Chuang
SC
,
Boccia
S
,
Castellsague
X
,
Chen
C
, et al.
Interaction between tobacco and alcohol use and the risk of head and neck cancer: pooled analysis in the International Head and Neck Cancer Epidemiology Consortium
.
Cancer Epidemiol Biomarkers Prev
.
2009
Feb
;
18
(
2
):
541
50
.
[PubMed]
1055-9965
13.
Rosen
CA
,
Lee
AS
,
Osborne
J
,
Zullo
T
,
Murry
T
.
Development and validation of the voice handicap index-10
.
Laryngoscope
.
2004
Sep
;
114
(
9
):
1549
56
.
[PubMed]
0023-852X
14.
Gillespie
AI
,
Gooding
W
,
Rosen
C
,
Gartner-Schmidt
J
.
Correlation of VHI-10 to voice laboratory measurements across five common voice disorders
.
J Voice
.
2014
Jul
;
28
(
4
):
440
8
.
[PubMed]
0892-1997
15.
Martins
RH
,
do Amaral
HA
,
Tavares
EL
,
Martins
MG
,
Gonçalves
TM
,
Dias
NH
.
Voice disorders: etiology and diagnosis
.
J Voice
.
2016
Nov
;
30
(
6
):
761.e1
9
.
[PubMed]
0892-1997
16.
Zhang
GP
.
Neural networks for classification: a survey. IEEE Trans Syst, Man, Cybern
.
[Applications and Reviews]
.
Part C
.
2000
;
30
(
4
):
451
62
.
17.
Curram
SP
,
Mingers
J
.
Neural networks, decision tree induction and discriminant analysis: an empirical comparison
.
J Oper Res Soc
.
1994
;
45
(
4
):
440
50
. 0160-5682
18.
Caruana
R
,
Niculescu-Mizil
A
.
An empirical comparison of supervised learning algorithms.
Proceedings of the 23rd international conference on Machine learning
.
2006
;
161
-
8
.
19.
Kotsiantis
SB
.
Supervised machine learning: a review of classification techniques
.
Informatica.
2007
;
31
:
249
68
.
20.
Hsu
YC
,
Lin
FC
,
Wang
CT
.
Optimization of the Minimal Clinically Important Difference of the Mandarin Chinese Version of 10-Item Voice Handicap Index
.
J Taiwan Otolaryngol Head Neck Surg
.
2017
;
52
:
8
14
.
21.
Baken
RJ
,
Orlikoff
RF
.
Clinical Measurement of Speech and Voice
.
Thomson
;
2000
.
22.
Woo
P
.
Stroboscopy
.
Plural Publishing
;
2009
.
23.
Breiman
L
,
Friedman
JH
,
Olshen
RA
,
Stone
CJ
.
Classification and regression trees
.
Chapman & Hall
;
1984
.
24.
Fisher
RA
.
The use of multiple measurements in taxonomic problems
.
Ann Hum Genet
.
1936
;
7
:
179
88
.0003-4800
25.
Altman
NS
.
An introduction to kernel and nearest-neighbor nonparametric regression
.
Am Stat
.
1992
;
46
(
3
):
175
85
.0003-1305
26.
Cortes
C
,
Vapnik
V
.
Support-vector networks
.
Mach Learn
.
1995
;
20
(
3
):
273
97
. 0885-6125
27.
Allwein
EL
,
Schapire
RE
,
Singer
Y
.
Reducing multiclass to binary: a unifying approach for margin classifiers
.
J Mach Learn Res
.
2000
;
1
:
113
41
.1532-4435
28.
Refaeilzadeh
P
,
Tang
L
,
Liu
H
.
Cross-validation
.
Encycl Database Syst
;
2009
. pp.
532
8
.
29.
Mardia
KV
.
Measures of multivariate skewness and kurtosis with applications
.
Biometrika
.
1970
;
57
(
3
):
519
30
. 0006-3444
30.
Li
T
,
Zhu
S
,
Ogihara
M
.
Using discriminant analysis for multi-class classification: an experimental investigation
.
Knowl Inf Syst
.
2006
;
10
(
4
):
453
72
. 0219-1377
31.
Hastie
T
,
Tibshirani
R
,
Friedman
J
.
The elements of statistical learning: data mining, inference, and prediction. Springer Series in Statistics
.
Springer-Verlag
;
2009
.
32.
Simberg
S
,
Sala
E
,
Laine
A
,
Rönnemaa
AM
.
A fast and easy screening method for voice disorders among teacher students
.
Logoped Phoniatr Vocol
.
2001
;
26
(
1
):
10
6
.
[PubMed]
1401-5439
33.
Niebudek-Bogusz
E
,
Kuzańska
A
,
Woznicka
E
,
Sliwinska-Kowalska
M
.
Assessment of the voice handicap index as a screening tool in dysphonic patients
.
Folia Phoniatr Logop
.
2011
;
63
(
5
):
269
72
.
[PubMed]
1021-7762
34.
Byeon
H
.
The risk factors of laryngeal pathology in Korean adults using a decision tree model
.
J Voice
.
2015
Jan
;
29
(
1
):
59
64
.
[PubMed]
0892-1997
35.
Awan
SN
,
Roy
N
,
Zhang
D
,
Cohen
SM
.
Validation of the cepstral spectral index of dysphonia (CSID) as a screening tool for voice disorders: development of clinical cutoff scores
.
J Voice
.
2016
Mar
;
30
(
2
):
130
44
.
[PubMed]
0892-1997
36.
Mozzanica
F
,
Ginocchio
D
,
Barillari
R
,
Barozzi
S
,
Maruzzi
P
,
Ottaviani
F
, et al.
Prevalence and voice characteristics of laryngeal pathology in an Italian voice therapy-seeking population
.
J Voice
.
2016
Nov
;
30
(
6
):
774.e13
21
.
[PubMed]
0892-1997
37.
Roy
N
,
Merrill
RM
,
Gray
SD
,
Smith
EM
.
Voice disorders in the general population: prevalence, risk factors, and occupational impact
.
Laryngoscope
.
2005
Nov
;
115
(
11
):
1988
95
.
[PubMed]
0023-852X
38.
Butler
JE
,
Hammond
TH
,
Gray
SD
.
Gender-related differences of hyaluronic acid distribution in the human vocal fold
.
Laryngoscope
.
2001
May
;
111
(
5
):
907
11
.
[PubMed]
0023-852X
39.
Lam
PK
,
Chan
KM
,
Ho
WK
,
Kwong
E
,
Yiu
EM
,
Wei
WI
.
Cross-cultural adaptation and validation of the Chinese Voice Handicap Index-10
.
Laryngoscope
.
2006
Jul
;
116
(
7
):
1192
8
.
[PubMed]
0023-852X
40.
Fang
SH
,
Tsao
Y
,
Hsiao
MJ
,
Chen
JY
,
Lai
YH
,
Lin
FC
, et al.
Detection of pathological voice using cepstrum vectors: a deep learning approach
.
J Voice
.
2018
Mar
;
S0892-1997(17)30509-X
.
[PubMed]
1873-4588
41.
Ngiam
J
,
Khosla
A
,
Kim
M
,
Nam
J
,
Lee
H
.
Ng AY. Multimodal deep learning.
In
Proceedings of ICML
,
689
-
696
,
2011
.
42.
Hou
JC
,
Wang
SS
,
Lai
YH
,
Tsao
Y
,
Chang
HW
,
Wang
HM
.
Audio-visual speech enhancement using multimodal deep convolutional neural networks
.
IEEE Transactions on Emerging Topics in Computational Intelligence
.
2018
;
2
(
2
):
117
28
.
43.
Uloza
V
.
Effects on voice by endolaryngeal microsurgery
.
Eur Arch Otorhinolaryngol
.
1999
;
256
(
6
):
312
5
.
[PubMed]
0937-4477
44.
Aaltonen
LM
,
Rautiainen
N
,
Sellman
J
,
Saarilahti
K
,
Mäkitie
A
,
Rihkanen
H
, et al.
Voice quality after treatment of early vocal cord cancer: a randomized trial comparing laser surgery with radiation therapy
.
Int J Radiat Oncol Biol Phys
.
2014
Oct
;
90
(
2
):
255
60
.
[PubMed]
0360-3016
Copyright / Drug Dosage / Disclaimer
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
You do not currently have access to this content.