ArticlemedRxiv : the preprint server for health sciences2025
Consensus-Based Definitions for Vocal Biomarkers: The International VOCAL Initiative.
Article in medRxiv : the preprint server for health sciences, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers, 1 of them a synthesis that pooled it.
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Who cites it
2 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Explainable and Interpretable AI for Voice and Speech Analysis in Clinical Care: Systematic Review.Journal of medical Internet research · 2026Pooled it
- Foundations for pediatric vocal biomarkers: age-aware phoneme recognition and latent-space error analysis.Frontiers in human neuroscience · 2026Article
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Authors and funding
26 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
importanceVoice-based health technologies are growing rapidly, but they lack standardized terminology, which hinders interdisciplinary collaboration, research quality, and clinical translation.
objectiveThe objective of this work is to develop universally accepted definitions in the rapidly evolving field of vocal biomarkers, as part of the VOCAL (Vocal Biomarker Guidelines for Ontology, Classification, Application, and Logistics) initiative, a structured, international consensus-based framework that aims to provide standards, and guidelines.
designVOCAL is a rigorous, international, multi-stage consensus-building study conducted in 2024-2025.
settingMulti-institutional collaboration between representatives from the Bridge2AI-Voice Consortium (North America) and the eVoiceNet Network (European Union), culminating in an in person workshop at the 2025 Bridge2AI Voice Symposium.
participantsA group of 24 international experts in medicine, clinical research, speech and language, audio signal processing, statistics, methodology, regulation, ethics.
methodsVOCAL's iterative process involved five rounds of review, feedback, and an in-person workshop at the international 2025 Bridge2AI Voice Symposium, ensuring the incorporation of diverse perspectives and achieving a robust agreement on the proposed definitions. MAIN OUTCOMES AND MEASURES: Consensus-based definitions for vocal biomarkers, spanning from broad concepts (biomarker, digital biomarker, vocal biomarker) to domain-specific measures (cardio-respiratory acoustic, voice, speech/articulatory, cognitive/language).
resultsA hierarchical continuum model of vocal biomarkers was established. We first distinguished between the concepts of vocal measures and vocal biomarkers. We then defined terms from broad, overarching concepts (Level 0: Biomarker, Digital Biomarker, Vocal Biomarker) to more specific physiological and cognitive domains (Level 1: Cardio-Respiratory Acoustic; Level 2: Voice; Level 3: Speech/Articulatory; Level 4: Cognitive/Language, including linguistic and paralinguistic subtypes). CONCLUSIONS AND RELEVANCE: This work provides a shared vocabulary that is essential for fostering communication through interdisciplinary collaboration, improving the quality and efficiency of research and development, and ensuring the ethical, reliable, and scalable deployment of future voice-based health technologies. It lays foundational groundwork for upcoming guidelines and standards, which are crucial for advancing the field of vocal biomarkers into widespread clinical utility.
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Registered trials
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