# Ambulatory monitoring of a vocal efficiency index to improve the clinical management of voice disorders

> **NIH NIH R01** · MASSACHUSETTS GENERAL HOSPITAL · 2021 · $357,000

## Abstract

Project Summary/Abstract
In the United States, voice disorders affect approximately 30% of the adult population at some point in their lives,
with about 25 million individuals suffering at any given point in time. The impact of living with a voice disorder is
far-reaching, and the societal burden reaches up to $13.5 billion dollars each year due to work-related disability,
lost productivity, and direct healthcare costs. Individuals with voice disorders often suffer from heightened
sensations of vocal effort and fatigue while speaking that are typically attributed to inefficient vocal function and
behavior. Increasing vocal efficiency and decreasing vocal effort and associated vocal fatigue are often goals of
clinical treatment paradigms. Thus, vocal efficiency is a highly desirable objective measure for the clinical
management of voice disorders, particularly if it can be obtained via ambulatory monitoring to track vocal health
and vocal behavior in a patient’s natural environment.
The proposed project seeks to develop an index of ambulatory vocal efficiency that integrates estimates of
subglottal pressure and vocal sound pressure level to monitor the vocal effort of patients being treated for
phonotraumatic vocal cord lesions, non-phonotraumatic vocal hyperfunction, and unilateral vocal fold paralysis.
Individuals with healthy vocal status will also be monitored as control subjects matched for sex, age, and
occupational/vocal demands. An innovative wearable sensor technology using flexible circuits obtains
synchronized data from a wireless neck-surface accelerometer and microphone to track the index of ambulatory
vocal efficiency in real-world settings. Integrating the technology into a smartphone platform enables periodic
prompting to prompt subjects to rate their level of vocal effort on a visual analog scale. The proposed work
pursues critical goals of (a) investigating the clinical validity of the ambulatory vocal efficiency index in patients
with voice disorders and vocally healthy matched controls and (b) assessing the ambulatory vocal efficiency
index as an objective correlate of self-ratings of vocal effort. The impact of this work is significant because, for
the first time, voice clinicians will be able to monitor vocal efficiency in naturalistic, real-world settings to improve
the prevention, diagnosis, and treatment of voice disorders.

## Key facts

- **NIH application ID:** 10295970
- **Project number:** 1R01DC019083-01A1
- **Recipient organization:** MASSACHUSETTS GENERAL HOSPITAL
- **Principal Investigator:** Daryush Dinyar Mehta
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2021
- **Award amount:** $357,000
- **Award type:** 1
- **Project period:** 2021-09-01 → 2026-05-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10295970

## Citation

> US National Institutes of Health, RePORTER application 10295970, Ambulatory monitoring of a vocal efficiency index to improve the clinical management of voice disorders (1R01DC019083-01A1). Retrieved via AI Analytics 2026-05-25 from https://api.ai-analytics.org/grant/nih/10295970. Licensed CC0.

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