Evidence map›Paper›PMID 40802550›Full record

ArticleAmerican journal of speech-language pathology2025

Simplified Vocal Efficiency Metrics Normalize Following Voice Therapy in Subgroups of Patients With Nonphonotraumatic Vocal Hyperfunction.

Zilan Zhu, Jarrad H Van Stan, Hamzeh Ghasemzadeh, Ahsan J Cheema, Jeremy Wolfberg, Robert E Hillman, Annie B Fox, Daryush D Mehta

Abstract read
In one paragraph

Article in American journal of speech-language pathology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
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

8 authors.

Zilan ZhuMGH Institute of Health Professions, Boston, MA.ORCID 0000-0001-6119-2788
Jarrad H Van StanMGH Institute of Health Professions, Boston, MA.ORCID 0000-0001-8932-3276
Hamzeh GhasemzadehCenter for Laryngeal Surgery and Voice Rehabilitation, Massachusetts General Hospital, Boston.ORCID 0000-0001-5395-1908
Ahsan J CheemaCenter for Laryngeal Surgery and Voice Rehabilitation, Massachusetts General Hospital, Boston.
Jeremy WolfbergMGH Institute of Health Professions, Boston, MA.ORCID 0000-0002-8202-6743
Robert E HillmanMGH Institute of Health Professions, Boston, MA.ORCID 0000-0002-7374-994X
Annie B FoxMGH Institute of Health Professions, Boston, MA.ORCID 0000-0002-4776-1873
Daryush D MehtaMGH Institute of Health Professions, Boston, MA.ORCID 0000-0002-6535-573X

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
TRAINING FOR SPEECH AND HEARING SCIENCEST32DC000038 · NIDCD · MASSACHUSETTS INSTITUTE OF TECHNOLOGY · PI Gwenaelle S Geleoc · 1992 to 2026
$21.8M
Ambulatory monitoring of vocal function to improve voice disorder assessmentR33DC011588 · NIDCD · MASSACHUSETTS GENERAL HOSPITAL · PI HILLMAN, ROBERT E · 2012 to 2015
$2.3M
Ambulatory monitoring of a vocal efficiency index to improve the clinical management of voice disordersR01DC019083 · NIDCD · MASSACHUSETTS GENERAL HOSPITAL · PI MEHTA, DARYUSH DINYAR · 2021 to 2025
$1.8M
Non-invasive estimation of subglottal pressure during natural speech to improve clinical voice assessmentR21DC015877 · NIDCD · MASSACHUSETTS GENERAL HOSPITAL · PI MEHTA, DARYUSH DINYAR · 2017 to 2019
$513k
NIDCD NIH HHS P50 DC015446NIDCD NIH HHS R01 DC019083NIDCD NIH HHS R21 DC015877NIDCD NIH HHS R33 DC011588NIDCD NIH HHS T32 DC000038
6 · The paper itself

Abstract

purposeThe purpose of this study is to determine whether simplified vocal efficiency (VE) metrics could accurately identify changes after voice therapy in individuals with nonphonotraumatic vocal hyperfunction (NPVH). This study analyzes treatment-related changes for traditional VE-vocal intensity (square of sound pressure) over aerodynamic power-and three simplified VE ratios: (a) sound pressure level over aerodynamic power (SPL/AP), (b) SPL over subglottal pressure (SPL/Ps), and (c) SPL over airflow (SPL/AFLOW).

methodRetrospective data from 108 adults (80 females, 28 males) diagnosed with primary muscle tension dysphonia (associated with NPVH) and 208 vocally healthy adults (181 females, 27 males). Study participants produced repeated consonant-vowel utterances in comfortable and loud conditions before and after voice therapy, with acoustic SPL and aerodynamic measurements (Ps and AFLOW) derived. Pre- to posttherapy VE changes were analyzed using mixed-design analysis of variance models. In an exploratory analysis, patients were divided into three subgroups based on their pretherapy VE measures to investigate treatment effects within NPVH subgroups.

resultsPre- to posttherapy VE changes were not observed for the NPVH group as a whole. A subsequent subgroup analysis revealed treatment effects within female patients with NPVH exhibiting lower and higher than typical pretherapy VE metrics. SPL/Ps exhibited a treatment effect in both loudness conditions and migration toward normative ranges following therapy. Posttherapy changes were observed to varying degrees in both loudness conditions for traditional VE and simplified VE metrics of SPL/AP and SPL/AFLOW.

conclusionsVE ratios, especially SPL/Ps, demonstrate potential as metrics for evaluating the outcome of voice therapy in individuals with NPVH and aid in stratifying individuals with NPVH into subgroups compared to vocally healthy values. Further investigations are warranted to investigate the role of VE metrics in the assessment, treatment, and prevention of NPVH.

Indexed as

DysphoniaSpeech AcousticsVoice QualityVoice TrainingAdultAgedFemaleHumansMaleMiddle AgedPhonationRetrospective StudiesSpeech Production MeasurementTreatment OutcomeYoung Adult

Identifiers

PMID40802550
PMCPMC12452819

What OpenQuestion holds

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Registered trials

None linked

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.