Evidence map›Paper›PMID 33007164›Full record

ArticleAmerican journal of speech-language pathology2020

An Updated Theoretical Framework for Vocal Hyperfunction.

Robert E Hillman, Cara E Stepp, Jarrad H Van Stan, Matías Zañartu, Daryush D Mehta

Registry-linked trialAbstract read
In one paragraph

Article in American journal of speech-language pathology, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT05625191 (Defining Clinically Important Differences in Cepstral and Spectral Measures in Individuals With and Without Phonotrauma), which is not on this map. Cited by 85 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
85citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT05625191 recruitingnot on this mapstarted 2023, after this paper: background citation

Defining Clinically Important Differences in Cepstral and Spectral Measures in Individuals With and Without Phonotrauma

TypeobservationalSponsorUniversity of Texas Southwestern Medical CenterRan2023 to 2026Enrolled100ConditionsPhonotraumaArmsAcoustic voice analysis, High-speed videoendoscopy
3 · Its place in the literature

Who cites it

85 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. The Fundamental Frequency of Voice as a Potential Stress Biomarker: A Systematic Review and Meta-Analysis.Stress and health : journal of the International Society for the Investigation of Stress · 2025
    Pooled it
  2. Trial
  3. Article
  4. Machine learning surrogate forward models for biomechanical laryngeal control.The Journal of the Acoustical Society of America · 2026
    Article
  5. Article
  6. Creak Derived from CAPE-V Sentences in Patients with AdLd and pMTD.Journal of voice : official journal of the Voice Foundation · 2026
    Article
  7. Psychometric and Acoustic Investigation of Identity and Phonotraumatic Vocal Hyperfunction.Journal of voice : official journal of the Voice Foundation · 2026
    Article
  8. Article
  9. Article
  10. Vocal Fold Vibratory Kinematics and Acoustic Correlates in Pressed and Breathy Phonation.Journal of speech, language, and hearing research : JSLHR · 2026
    Article
  11. Article
  12. Article
  13. Article
  14. Article
  15. Review
  16. Article
  17. The Lived Experience of Phonotrauma: Discussions on Identity and Stigma.American journal of speech-language pathology · 2026
    Article
  18. Article
  19. Article
  20. Article

25 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Robert E HillmanMassachusetts General Hospital, Boston.
Cara E SteppBoston University, MA.
Jarrad H Van StanMassachusetts General Hospital, Boston.
Matías ZañartuUniversidad Técnica Federico Santa María, Valparaíso, Chile.
Daryush D MehtaMassachusetts General Hospital, Boston.

Funding

Use of ambulatory biofeedback to improve behavioral treatment of vocal hyperfunctionP50DC015446 · NIDCD · MASSACHUSETTS GENERAL HOSPITAL · PI Jarrad Van Stan · 2017 to 2026
$25.5M
NIDCD NIH HHS P50 DC015446
6 · The paper itself

Abstract

Purpose The purpose of this viewpoint article is to facilitate research on vocal hyperfunction (VH). VH is implicated in the most commonly occurring types of voice disorders, but there remains a pressing need to increase our understanding of the etiological and pathophysiological mechanisms associated with VH to improve the prevention, diagnosis, and treatment of VH-related disorders. Method A comprehensive theoretical framework for VH is proposed based on an integration of prevailing clinical views and research evidence. Results The fundamental structure of the current framework is based on a previous (simplified) version that was published over 30 years ago (Hillman et al., 1989). A central premise of the framework is that there are two primary manifestations of VH-phonotraumatic VH and nonphonotraumatic VH-and that multiple factors contribute and interact in different ways to cause and maintain these two types of VH. Key hypotheses are presented about the way different factors may contribute to phonotraumatic VH and nonphonotraumatic VH and how the associated disorders may respond to treatment. Conclusions This updated and expanded framework is meant to help guide future research, particularly the design of longitudinal studies, which can lead to a refinement in knowledge about the etiology and pathophysiology of VH-related disorders. Such new knowledge should lead to further refinements in the framework and serve as a basis for improving the prevention and evidence-based clinical management of VH.

Indexed as

VoiceVoice DisordersHumans

Identifiers

PMID33007164
PMCPMC8740570

What OpenQuestion holds

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.