Evidence map›Paper›PMID 41775605›Full record

ArticleJournal of voice : official journal of the Voice Foundation2026

Performance of Nonlinear Energy Difference Ratio and Voice Type Component Profile Across Phoneme, Relative Sound Pressure Level, and Environment.

Ashvath Madhushankar, Jakob R Holm, Kelly Y Shih, Owen P Wischhoff, Rachel H Emanuel, Jack J Jiang

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Journal of voice : official journal of the Voice Foundation, 2026. 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

6 authors.

Ashvath MadhushankarDepartment of Otolaryngology-Head and Neck Surgery, University of Wisconsin School of Medicine and Public Health Madison, Wisconsin.
Jakob R HolmDepartment of Otolaryngology-Head and Neck Surgery, University of Wisconsin School of Medicine and Public Health Madison, Wisconsin.
Kelly Y ShihDepartment of Otolaryngology-Head and Neck Surgery, University of Wisconsin School of Medicine and Public Health Madison, Wisconsin.
Owen P WischhoffDepartment of Otolaryngology-Head and Neck Surgery, University of Wisconsin School of Medicine and Public Health Madison, Wisconsin.
Rachel H EmanuelDepartment of Otolaryngology-Head and Neck Surgery, University of Wisconsin School of Medicine and Public Health Madison, Wisconsin.
Jack J JiangDepartment of Otolaryngology-Head and Neck Surgery, University of Wisconsin School of Medicine and Public Health Madison, Wisconsin. Electronic address: jjjiang@wisc.edu.

Funding

Chaos in Human Phonation and Its MeasurementR01DC006019 · NIDCD · UNIVERSITY OF WISCONSIN-MADISON · PI JIANG, JACK J · 2003 to 2023
$4.8M
Estimating and Mitigating Thyroid Cancer Overdiagnosis: A Mathematical Modeling ApproachR01CA251566 · NCI · UNIVERSITY OF WISCONSIN-MADISON · PI ALAGOZ, OGUZHAN, FRANCIS, DAVID O. · 2020 to 2024
$2.6M
NCI NIH HHS R01 CA251566NIDCD NIH HHS R01 DC006019
6 · The paper itself

Abstract

introductionNonlinear energy difference ratio (NEDR) and voice type component profile (VTCP) are reliable acoustic metrics for voice classification; however, their performance under varying vocal intensities, speech sounds, and recording environments has not been thoroughly established. This study examined the effectiveness of these measures under real-world variability with different phonemes, sound intensities, and environments to help determine their clinical diagnostic potential.

methodsThirty-one normophonic adults produced sustained vowels (/a/, /i/, /u/) and fricatives (/s/, /z/) at five nominal sound pressure levels from very soft (L1), soft (L2), baseline (L3), loud (L4), and very loud (L5). The vowel /a/ was also recorded in sound-attenuated and noise-masked environments to elucidate the environmental effects on reliability. Trimmed 0.75-second samples were analyzed in MATLAB to compute NEDR and VTCP values. Repeated-measures analysis of variances tested the effects of intensity, sound type, and environment for NEDR and VTCP.

resultsNEDR remained stable across vowels and voiced fricatives, with deviations limited to very soft phonation (L1) and the voiceless fricative /s/. VTCP was more sensitive to changes, particularly at low intensities and in noisy environments, with voice types 3 and 4 frequently misclassifying healthy phonations as disordered. Across environments, NEDR showed greater robustness than VTCP.

conclusionNEDR demonstrates relative stability across vocal intensity, phoneme type, and recording environment, supporting its potential clinical utility, including in telepractice and nonsoundproof settings. Its susceptibility to very low intensities and voiceless fricatives highlights the need for cautious interpretation and further validation in disordered populations.

Indexed as

FricativesNonlinear energy difference ratio (NEDR)PhonemeVoice classificationVoice type component profile (VTCP)

Identifiers

PMID41775605
PMCPMC12958462

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Registered trials

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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.