Accuracy and cut-off values of different acoustic measures in the sustained vowel task of Brazilian Portuguese speakers

Feliciano, Amanda; Behlau, Mara; Balbinot, Jordana; Abreu, Samuel Ribeiro de; Ribeiro, Vanessa Veis; Lopes, Leonardo Wanderley

doi:10.1590/2317-1782/e20250288pt

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Original Article • CoDAS 38 (4) • 2026 • https://doi.org/10.1590/2317-1782/e20250288en linkcopy

Accuracy and cut-off values of different acoustic measures in the sustained vowel task of Brazilian Portuguese speakers

Authorship SCIMAGO INSTITUTIONS RANKINGS

Purpose To define cut-off values for acoustic measures extracted from the sustained vowel [a] task to discriminate between the presence and absence of vocal disorders in Brazilian Portuguese speakers.

Methods The sample consisted of 376 participants, 288 female and 88 male, with a mean age of 41.20 ± 14.04 years. All individuals underwent a laryngological evaluation and a voice recording session, during which a sustained vowel [a] sample was collected. Subsequently both auditory-perceptual and acoustic analyses of the voice were performed. Among the participants 277 were classified as having a vocal disorder and 99 as having no vocal disorder. A total of 44 acoustic measures were extracted and analyzed using ROC curves to determine the cut-off value for each measure, along with their performance metrics (sensitivity, specificity and AUC).

Results Cut-off values were established for 23 of the 44 extracted acoustic measures. Six measures showed robust and clinically relevant performance in discriminating between voices with and without vocal disorders in Brazilian Portuguese speakers. The measures with AUC values greater than 0.70 and balanced sensitivity and specificity above 70% were: Amplitude Variability Index (AVI) (≤0,91), Glottal-to-noise excitation (GNE)2000Hz (>0,92), Spectral Noise Level (SNL)100-2600Hz (≤7,71), SNL100-3000Hz (≤3,38), SNL100-8000Hz (≤10,95) and SNL5100-8000Hz (≤–1,84).

Conclusion Six acoustic measures demonstrated satisfactory performance in identifying the presence of vocal disorders in Brazilian Portuguese speakers. Ten measures showed good performance for voice screening purposes and seven for diagnostic confirmation of vocal disorders.

Keywords:
Voice; Acoustic; Voice Disorders; Dysphonia; Diagnostic

Acoustic Measures	Cutoff	AUC	Sensitivity (%)	Specificity(%)	+LR	-LR	+PV	-PV
AVI	≤ 0.91	0.779	70.97	76.49	3.02	0.38	25.9	95.8
GNE_{2000 Hz}	>0.92	0.785	70.97	73.61	2.69	0.39	23.7	95.7
SNL_{100-2600 Hz}	≤7.71	0.808	83.87	72.12	3.01	0.22	25.7	97.5
SNL_{100-3000 Hz}	≤3.38	0.816	77.42	80.67	4	0.28	31.6	96.9
SNL_{100-8000 Hz}	≤10.95	0.814	90.32	70.63	3.08	0.14	26.2	98.4
SNL_{5100-8000 Hz}	≤-1.84	0.747	70.97	73.61	2.69	0.39	23.7	95.7
GNE_1000Hz	>0.92	0.76	83.87	54.65	1.85	0.3	17.6	96.7
HNR	>20.73	0.837	90.32	64.68	2.56	0.15	22.8	98.3
LNPSD	≤-9.58	0.722	93.55	48.88	1.83	0.13	17.5	98.5
PA	>0.91	0.709	70.97	61.34	1.84	0.47	17.5	94.8
PSD	≤0.00	0.722	93.55	48.88	1.83	0.13	17.5	98.5
SHIMMER_{APQ 5}	≤2.26	0.779	93.55	51.12	1.91	0.13	18.1	98.6
SHIMMER_{APQ 11}	≤2.78	0.792	100	51.31	2.05	0	19.3	100
SHIMMER_DB	≤0.24	0.78	77.42	66.04	2.28	0.34	20.9	96.2
SHIMMER_local	≤2.78	0.776	77.42	65.67	2.26	0.34	20.7	96.2
SNL_{100-5100 Hz}	≤11.44	0.807	90.32	69.52	2.96	0.14	25.5	98.4
GNE_{3000 Hz}	>0.9	0.76	64.52	82.16	3.62	0.43	29.4	95.3
HNR D	>29.78	0.72	61.29	76.21	2.58	0.51	22.9	94.5
JITTER_local	≤0.31	0.712	67.74	70.9	2.33	0.46	21.2	95
JITTER_PPQ5	≤0.18	0.725	67.74	70.9	2.33	0.46	21.2	95
SHIMMER_{APQ 3}	≤1.18	0.765	64.52	74.63	2.54	0.48	22.7	94.8
SHIMMER_DDA	≤3.54	0.765	64.52	75	2.58	0.47	23	94.8
SNL_{2600-5100 HZ}	≤1.21	0.743	54.84	83.27	3.28	0.54	27.4	94.1

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[1] Caption: Cutoff: Cutoff value for the acoustic measure.. AUC - Area Under the Curve. +LR: Positive likelihood ratio. Negative likelihood ratio. +PV: Positive predictive value. -PV: Negative predictive value. AVI – Amplitude Variability Index. GNE - Glottal-to-Noise Excitation - GNE_1000Hz, GNE_2000Hz, GNE_3000Hz. SNL - Spectral Noise Level - SNL_100-2600Hz, SNL_100–3000Hz, SNL_{100–5100Hz,} SNL_100–8000Hz, SNL_{2600–5100Hz}, SNL_{5100–8000Hz.} HNR – Harmonic-to-noise-ratio. LNPSD – Natural logarithm of the standard deviation of the period. PA – Pitch amplitude. PSD – Period standard deviation. Shimmer_APQ5, shimmer_APQ11, shimmer_dB, shimmer_local, shimmer_APQ3, shimmer_DDA. HNR D – Harmonic-to-noise ratio Dejonckere. Local Jitter, Jitter_{PPQ5 -} Jitter period perturbation quotient.