성대마비의 음성장애 측정을 위한 청지각적 및 음향학적 평가

김근효,이연우,박희준,배인호,이병주,권순복,Kim, Geun-Hyo,Lee, Yeon-Woo,Park, Hee-June,Bae, In-Ho,Lee, Byung-Joo,Kwon, Soon-Bok 대한후두음성언어의학회 2017 대한후두음성언어의학회지 Vol.28 No.2

Background and Objectives : The purpose of this study was to investigate the criterion-related concurrent validity of two standardized auditory-perceptual assessments and the Acoustic Voice Quality Index (AVQI) for measuring dysphonia severity in patients with vocal cord paralysis (VCP). Materials and Methods : Total 210 patients with VCP and 236 normal voice subjects were asked to sustain the vowel [a:] and to read aloud the Korean text "Walk". A 2 second mid-vowel portion of the sustained vowel and two sentences (with 26 syllables) were recorded. And then voice samples were edited, concatenated, and analyzed according to Praat script. Two standardized auditory-perceptual assessment (GRBAS and CAPE-V) were performed by three raters. Results : The VCP group showed higher AVQI, Grade (G) and Overall Severity (OS) values than normal voice group. And the correlation among AVQI, G, and OS ranged from 0.904 to 0.926. In ROC curve analysis, cutoff values of AVQI, G, and OS were <3.79, <0.00, and <30.00, respectively, and the AUC of each analysis was over .89. Conclusion : AVQI and auditory evaluation can improve the early screening ability of VCP voice and help to establish effective diagnosis and treatment plan for VCP-related dysphonia.

정상과 말운동장애 성인에서의 모음공간 특성 비교 연구

김근효(Geun Hyo Kim),이연우(Yeon Woo Lee),류재경(Jae Gyeong Ryu),권순복(Soon Bok Kwon) 한국언어치료학회 2021 言語治療硏究 Vol.30 No.2

Effect of Mobile-Based Voice Therapy on the Voice Quality of Patients with Dysphonia: A Randomized Controlled Pilot Trial

Geun-Hyo Kim(김근효),Yeon-Woo Lee(이연우),In-Ho Bae(배인호),Hee-June Park(박희준),Soon-Bok Kwon(권순복) 한국언어치료학회 2020 한국언어치료학회 학술발표대회 논문집 Vol.2020 No.11

성대결절 환자의 음성장애에 대한 청지각적 및 음향학적 평가

김근효(Geun-Hyo Kim),권순복(Soon-Bok Kwon) 한국콘텐츠학회 2018 한국콘텐츠학회논문지 Vol.18 No.1

본 연구의 목적은 정상 집단과 성대결절 집단의 음성을 음향학적 측정(AVQI), 청지각적 평가(GRBAS, CAPE-V)를 수행하여 그 차이와 상관관계를 조사하는 것이다. 이를 위해 성대결절 환자 335명의 음성 샘플을 음향학적으로 분석하고, 3명의 평가자를 통해서 청지각적 평가를 실시하였다. 연구결과, 정상 집단의 AVQI, grade(G), overall severity(OS) 점수는 성대결절 집단의 점수보다 낮게 평가되었다. 청지각적 척도간의 상관관계에서는 GRBAS의 G 척도와 CAPE-V의 OS 척도는 상관관계가 높은 것으로 나타났고, 음향학적 측정 AVQI와 G, OS 간의 상관관계도 높은 것으로 확인되었다. 두 집단 간의 AVQI, G, OS를 감별하는 역치값은 각각 ≤4.06, ≤1, ≤26 였으며, 예측진단력은 0.840, 0.860,0.848이었다. 결론적으로 AVQI와 청지각적 평가를 통하여 성대결절 음성에 대한 선별 가능성을 높일 수 있고, 음성장애의 진단 및 치료 계획수립에 도움을 줄 것으로 사료된다. The purpose of this study was to investigate the relationship between the differences in the acoustic measurements (AVQI) and the auditory-perceptual assessments (GRBAS, CAPE-V) of the normal and vocal fold nodules. For this purpose, Total 335 voice samples were analyzed acoustically and three raters performed auditory-perceptual assessments. in the results, AVQI, G, and OS scores of the normal group were lower than those of the vocal fold nodules group. The correlations between the G scale and the OS scale were highly correlated, and the correlation between the AVQI, and auditory-perceptual results (G and OS) was also high value. The threshold values for discriminating AVQI, G, and OS between the two groups were ≤4.06, ≤1, and ≤26, respectively, and the predictive diagnostic power was 0.840, 0.860, and 0.848. In conclusion, AVQI and auditory-perceptual evaluation can improve potentiality the screening of vocal fold nodules and help to determine the diagnosis and treatment plan of voice disorders.

음성 떨림에 대한 음향학적 측정: 파일럿 연구

김근효(Geun-Hyo Kim),임동원(Dong-Won Lim),김재원(Jae-Won Kim),이연우(Yeon-Woo Lee) 한국언어치료학회 2022 한국언어치료학회 학술발표대회 논문집 Vol.2022 No.11

한국인 화자에서 새로운 버전의 Acoustic Voice Quality Index 적용

김근효(Geun-Hyo Kim),이연우(Yeon-Yoo Lee),배인호(In-Ho Bae),박희준(Hee-June Park),권순복(Soon-Bok Kwon) 한국언어청각임상학회 2018 Communication Sciences and Disorders Vol.23 No.4

배경 및 목적: 본 연구에서는 한국인 화자에서 정상음성과 병리적 음성을 정량화하는 Acoustic Voice Quality Index (AVQI)의 새로운 회귀식을 제시하여 기존의 회귀식(AVQIv2, AVQIv3)과 비교하고자 하였다. 또한 AVQI 측정치와 청지각적 평가 간의 상관관계도 알아 보고, 정상과 병리적 음성을 감별할 수 있는 최적의 절사값 및 진단 예측력도 알아보았다. 방법: 한국인 화자 2,369명으로부터 모음연장 발성 /아/ 5초와 표준문단 ‘산책’ 읽기를 통해서 녹음하였다. 모음의 안정구간 2초와 읽기샘플 25음절을 연결하여 Praat 스크립트를 적용하여 유성음 분절을 추출하고 AVQI를 측정하였다. 또한 음성장애의 중증도를 평가하기 위해서, 5명의 언어재활사가 두 가지 청지각적 평가(GRBAS의 Grade척도, CAPE-V의 overall severity 척도)를 사용하였다. 결과: 전체 AVQI 측정치는 AVQIv2, AVQIv4-K, AVQIv3 순으로 높았으며, AVQIv3는 나머지 AVQI 측정치들에 비해서 유의미하게 낮았다. 각 버전 모두 정상과 병리적 음성 집단 간에 유의 미한 차이를 보였다. AVQI와 청지각적 평가 간에는 .82 이상의 높은 상관관계를 보였고, AVQIv4-K와 상관관계가 가장 높았다. ROC 분석을 통해서 모든 AVQI는 모두 .94 이상의 AUC, 9.5 이상의 LR(+), .2 이하의 LR(-)를 나타내었다. 논의 및 결론: AVQIv4-K는 기존 AVQI 버전에 상응하는 높은 수준의 진단적 성능을 가지는 것으로 여겨진다. Objectives: The purpose of the present study was to compute the new version of Acoustic Voice Quality Index (AVQI) and compare with existing AVQI versions. Additionally, we also investigated the correlation between AVQI measurements and auditory-perceptual ratings, and confirmed the optimal cutoff value and diagnostic predictive power to distinguish between normal and pathological voice. Methods: Voice samples of 2,369 native Korean subjects with normal voices (N= 143) and with dysphonia (N= 2,226) were recorded through both 5 seconds of sustained vowel /a/ and connected speech (Korean text “Walk”). We used the Praat script to extract the voiced segments and measure the AVQI. Additionally, two auditory-perceptual ratings (grade in GRBAS and overall severity in CAPE-V) were used by five speech language pathologists to assess the voice disorder severity. Results: Overall AVQI measurements were higher in order of AVQIv2, AVQIv4-K and AVQIv3; and AVQIv3 was significantly lower than other AVQI measures. In each version, there was a significant difference between normal and pathological voice groups. The correlation between AVQI and auditory evaluation was above .82, and the correlation with AVQIv4-K was the highest. All versions of the AVQI showed an above .94 for AUC, above 9.5 for LR(+), and below .2 for LR(–). Conclusion: AVQIv4-K is considered to have a high level of diagnostic power comparable to the existing AVQI versions.

정상과 말운동장애 환자의 모음공간 분석

김근효(Geun-Hyo Kim),이연우(Yeon-Woo Lee),류재경(Jae-Gyeong Ryu),권순복(Soon-Bok Kwon) 한국언어치료학회 2022 한국언어치료학회 학술발표대회 논문집 Vol.2022 No.11

성문암과 후두백반증 음성의 켑스트럼 분석 및 청지각적 평가

김근효(Geun Hyo Kim),이연우(Yeon Woo Lee),배인호(In Ho Bae),박희준(Hee June Park),이재석(Jae Seok Lee),왕수건(Soo Geun Wang),권순복(Soon Bok Kwon) 한국언어치료학회 2016 言語治療硏究 Vol.25 No.3

Purpose : Time-based acoustic perturbation has limitations because it cannot accurately extract the cycle of voice signals in non-periodic, rough, breathy voices. The purpose of this study is to compare the cepstral analysis between glottic cancer and laryngeal leukoplakia. Methods: Fifty male glottic cancer patients and fifty male vocal fold leukoplakia patients were evaluated. After their criteria were confirmed, signal analysis was performed using Analysis of Dysphonia in Speech and Voice (ADSV) and SpeechTool software. This study confirmed the correlation of the cepstral measures and GRBAS scale. Individuals were recorded reading a standard passage ('Sanchaek') and sustaining the vowel /A/. Cepstral measures were obtained for CPP (dB), L/H Spectral Ratio (dB), Mean CPP F0 (Hz), SpeechTool's CPPs, and Mean CPP F0 (Hz). Statistical analyses were applied to Independent-samples t-test in SPSS 19.0 and receiver operating characteristic in Med Calc. Results: The results revealed a significant result on measures of CPP (dB), L/H Spectral Ratio (dB), and Mean CPP F0 (Hz) in both groups. In a sample of glottic cancer speakers versus leukoplakia speakers, cepstral measures of CPP, L/H ratio, Mean CPP F0 were able to differentiate these groups from one another in both sustained vowel phonation and continuous speech contexts with high sensitivity and specificity. Conclusions: The results of this study support the growing body of literature documenting the significant value of cepstral based acoustic measures to the clinical evaluation and management processes.

ADSV, SpeechTool, Praat 간의 CPP 특성 연구

김근효(Geun Hyo Kim),이연우(Yeon Woo Lee),박희준(Hee June Park),배인호(In Ho Bae),권순복(Soon Bok Kwon) 한국언어치료학회 2017 言語治療硏究 Vol.26 No.3

Purpose: This study aimed to investigate the relationship and reliability of cepstral peak prominence (CPP) measures from three acoustic software applications: Analysis of Dysphonia in Speech and Voice (ADSV), SpeechTool and Praat. Methods: Korean recordings of sustained vowels and connected sentence samples in 65 patients with glottic cancer were analyzed using ADSV, SpeechTool, and Praat. GRBAS scale was used for auditory perceptual assessment. Pearson correlation analysis and measures of the standard error of the estimate were applied to the vowel and connected sentence data obtained from the three programs. Results: The CPP analysis value for the same voice was as follows. The degree of CPP value was in the order of Praat, ADSV and SpeechTool. Praat vowel (9.41±4.02), ADSV vowel (5.87±3.78), ST vowel (4.44±3.14), Praat sentence (6.75±2.18), ADSV sentence (3.87±2.14) and ST sentence (3.04±1.46) were calculated. Pearson correlation analysis revealed strong relationships (eg. r>0.95) among CPP measures derived from ADSV, those derived from SpeechTool, and those derived from Praat, regardless of context type. Additionally, we confirmed the significant relationship between CPP values and GRBAS scale, especially, results of G (-0.697~-.866, p<0.01), R (-0.375~-0.426, p<0.01), B (-0.634~-0.756, p<0.01) and S (-0.557~-0.654, p<0.01). Furthermore, average residual errors ranged from 0.41 to 1.12 dB for the prediction of one CPP data from other actual observed CPP data. Conclusions: Measurements of CPP derived from ADSV, SpeechTool, and Praat manifested strong parallel-form reliability. The strong measurement relationships indicate that CPP values from either program have a high degree of shared variance and may be expected to differentiate across a wide range of voice signal periodicity in a relatively similar fashion. This finding supports the use of the ethree programs in clinical use and voice science research.

Motor Speech Profile을 통한 한국 정상화자의 말수행력 특성 분석

김근효(Geun Hyo Kim),박희준(Hee June Park),배인호(In Ho Bae),이연우(Yeon Woo Lee),왕수건(Soo Geun Wang),권순복(Soon Bok Kwon) 한국언어치료학회 2015 言語治療硏究 Vol.24 No.2

Purpose: It is critical to implement objective analyses and comparison regarding speech performance in order to assess and understand sub-optimal verbal motor functions. So far, the Motor Speech Profile, a CSL sub program of KayPentax, has been widely utilized for objective speech performance analyses. It is however, difficult to adopt to make comparisons for normal Korean speakers given the threshold and reference values of the program were based on results obtained from foreign speakers. Thus, in the present study, speech performance of normal Korean speakers was analyzed using the Motor Speech Profile thereby providing/establish reference values for Korean. Methods: A total of 334 Korean adults (136 male and 198 female subjects) were enrolled for the study and categorized by age: 20-39 year old, 40-59 year old, and older than 60 year old. Within a normal range of pitch and strength, subject's voice was obtained while phonating vowel /a/ and then, repetition of vowel phonating (i-u), and diadochokinetic assessment (pa, ta, ka, a) were performed. Two experienced examiner edited for ranges of stable voice for further analyses. Results: When compared between sexes, 10 parameters showed statistical significant whilst it was demonstrated that multiple parameters were statistically reduced by each group. Variables related to the vF0, vAm, F2rate, /pa/DDKavp, /pa/DDKjit, /ta/DDKavr were more influenced by the group yet the F0, F2magn, F2aver related variables were rather impacted by subjects' gender. Conclusion: It is significant to establish reference values for speech performance through objective assessment tools. Given the scant information available, further investigations with regards to speech performance in normal Korean speakers may provide objective database to distinguish impaired speech performances resulted by normal aging processes from pathological consequences.