European Archives of Oto-Rhino-Laryngology

, Volume 275, Issue 4, pp 949–958 | Cite as

A comparison of Dysphonia Severity Index and Acoustic Voice Quality Index measures in differentiating normal and dysphonic voices

  • Virgilijus Uloza
  • Ben Barsties v. Latoszek
  • Nora Ulozaite-StanieneEmail author
  • Tadas Petrauskas
  • Youri Maryn



The aim of the study was to investigate and compare the feasibility and robustness of the Acoustic Voice Quality Index (AVQI) and the Dysphonia Severity Index (DSI) in diagnostic accuracy, differentiating normal and dysphonic voices.


A group of 264 subjects with normal voices (n = 105) and with various voice disorders (n = 159) were asked to read aloud a text and to sustain the vowel /a/. Both speech tasks were concatenated, and perceptually rated for dysphonia severity by five voice clinicians. They rated the Grade (G) and the overall dysphonia severity with a visual analog scale (VAS). All concatenated voice samples were acoustically analyzed to receive an AVQI score. For DSI analysis, the required voice parameters were obtained from the sustained phonation of the vowel /a/.


The results achieved significant and marked concurrent validity between both auditory-perceptual judgment procedures and both acoustic voice measures. The DSI threshold (i.e., DSI = 3.30) pertaining to Gmean obtained reasonable sensitivity of 85.8% and specificity of 83.4%. For VASmean, the DSI threshold of 3.30 was determined also with reasonable sensitivity of 70.3% and excellent specificity of 93.9%. Also, the AVQI threshold (i.e., AVQI = 3.31) pertaining to Gmean demonstrated reasonable sensitivity of 78.1% and excellent specificity of 92.0%. For VASmean, an AVQI threshold of 3.33 was determined with excellent sensitivity of 97.0% and reasonable specificity of 81.8%.


The outcomes of the present study indicate comparable results between DSI and AVQI with a high level of validity to discriminate between normal and dysphonic voices. However, a higher level of accuracy was yielded for AVQI as a correlate of auditory perceptual judgment suggesting a reliable voice screening potential of AVQI.


Dysphonia Acoustic Voice Quality Index Dysphonia Severity Index Acoustic voice analysis Voice assessment 


Compliance with ethical standards

Conflict of interest

The authors declare no conflict of interest.

Ethical approval

Lithuanian State Data Protection Inspectorate for Working with Personal Patient Data [No. 2R-648 (2.6-1)].

Informed consent

Informed consent was obtained from all individual participants included in the study.


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of OtolaryngologyLithuanian University of Health SciencesKaunasLithuania
  2. 2.Faculty of Medicine and Health SciencesUniversity of AntwerpAntwerpBelgium
  3. 3.Institute of Health StudiesHAN University of Applied SciencesNijmegenThe Netherlands
  4. 4.European Institute for ORLSint-Augustinus HospitalAntwerpBelgium
  5. 5.Department of Speech, Language and Hearing SciencesGhent UniversityGhentBelgium
  6. 6.Faculty of Education, Health & Social WorkUniversity College GhentGhentBelgium

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