Overview of Voice Disorder Identification by using

Machine Learning Techniques

Benkhay abdellah a , Daali noussaiba a

a
Faculty of Sciences of Rabat, Mohammed v University
Research Master in Computer Science and Telecommunications
Speech Processing

ARTICLE INFO ABSTRACT :

Keywords : Identification of voice disorders plays a basic part in our life these days. Therefore, many
of these diseases should be analyzed at beginning phases of case before they lead to a
Speech recognition
basic condition. Acoustic analysis can be used to identify voice disorders as a
Machine learning
corresponding strategy with other customary obtrusive techniques, such as
Voice disorders
laryngoscopy. Mobile technologies offer not only forms of communication for
Support Vector Machine
multimedia content clinical audio-visual notes and medical records yet additionally
(SVM)
encouraging answers for individuals who want the identification their health conditions
anywhere and whenever. In this paper, we present some of methods for voice disorders
classification based on machine learning methods, the identification of an algorithm that
discriminates between disorderly voices and healthy voices with more accuracy is
necessary to realize a valid and precise mobile health system. All analyses are performed
on a datasets of voices selected from SVD [7], MEEI [8] and AVPD [8].The results
obtained are evaluated in terms of accuracy, sensitivity and specificity and the main
classifier algorithm used is SVM.

INTRODUCTION: exploration and business networks. They offer, as a

Voice disorders by Wikipedia affect the ability to
speak normally. These disorders can incorporate
laryngitis, deadened vocal lines, and a nerve issue that
makes the vocal ropes fit. Your voice might tremble, be
rough, or sound stressed or uneven. Speech or, as a rule,
the voice signal is utilized in a few sorts of utilization
going from feeling acknowledgment [9] to patient
medical services state acknowledgment [10]. Amazon's
Alexa, Apple's Siri's, Google assistant, Microsoft's
Cortana and so forth are a portion of the present well-
known Automatic Speech Recognition ASR
frameworks. These are voice actuated computerized
aides and assist us in working environment, banking,
wellbeing with caring and so forth.
The voice definition is the sound delivered in an
individual's larynx and expressed through the mouth, as
discourse or melody. The introduction of mobile
devices for data transmission or disease control and
monitoring has been a principal fascination of
matter of fact, various chances to acknowledge effective
portable wellbeing frameworks. These arrangements
can permit patients and specialists to get to clinical
records, clinical general media notes and medication
data anyplace and whenever from their cell phones, like
a tablet or cell phone, to screen a few circumstances. In
recent years, probably also due to the diffusion of the
Internet of Things (IoT) and cloud technologies, there
has been a development of monitoring systems in an
unobtrusive, portable and easy way using wearable
sensors and wireless communications, such as the
solution describe in [1], [2], [3], [4], [5], [6]. Several
acoustic parameters are estimated to evaluate the state
of health of the voice. Unfortunately, the accuracy of
these parameters in the detection of voice disorders is,
often, related to the algorithms used to estimate them.
For this reason, the main effort of researchers is oriented
to the study of acoustic parameters and the application
of classification techniques able to obtain a high
1
discrimination accuracy. Recently, speech pathology
has focused interest on machine learning techniques.
This paper gives a meta-examination of the
important exploration articles that are straightforwardly
focusing on voice disorder and the data sets use for the
discovery and the AI methods utilized for the
recognition as made sense of. Shortly, this outline
covers every one of the three most famous data sets
SVD [7], MEEI [8] and AVPD [8].
The plan of this paper is organized as follows.
Section 1 gives a short introduction of voice disorders
and data sets we have targeted as related work. Section
2 provides the methodologies used to conduct this
overview. The finding of this systematic assessment is
mention in Section 3 of this paper. Section 4 deal with
the methodology that we choose to percent. The
conclusion of this whole paper is provided in section 5
with restrictions, research gaps and recommendations
for further investigations.
1. RELATED WORK
As we notes previously that in this overview, we are
going to give a meta-examination of the important
exploration articles that are straightforwardly focusing
on voice disorder and the data sets use for the discovery
and the AI methods utilized for the recognition as made
sense of. Shortly, this outline covers every one of the
three most famous data sets SVD [7], MEEI [8] and
AVPD [8].
There is so many studies focused on the
identification of parameters to measure the voice quality
and new techniques able to detect voice disorders. An
others studies focused on peer reviewed articles that
used machine learning to recognize voice disorders in
voice recordings. In fact, we concentrated mostly on the
related research papers with respect to these criteria in
order to understand the problem through machine
learning or implementation. This includes articles that
Table 1: Summary of the 30 selected studies with data extraction.
no Author/year DATASET
1 A. Al-Nasheri et al. /2017 SVD
[12] MEEI
AVPD
2 Zulfiqar Ali et al./2017 [13] SVD
MEEI
AVPD
3 Fonseca et al./2020 [14] SVD
4 Garcia et al./2019 [15] SVD
5 Guedes et al./2019 [16] SVD
6 Hammami et al./2020 [17] SVD
used voice recordings from SVD [7], MEEI [8] and
AVPD [8] database to detect voice disorder with a big
percentage. We will also ensure that selected research
papers use machine learning-based approaches.
All articles that do not include machine learning or
an algorithm in which the disease is defined will be
eliminated. This also excludes papers solely based on a
qualitative examination and not analyzed on basis of
accuracy and quantitative analyzes. This standers
showed the accuracy of machine learning algorithms
and its strategies applied in totally chosen article that are
quantitatively audited distributed.
Afterwards, we are going to present the
performance of a meta-analysis on the detection of
voice disorders using the SVD [7], MEEI [8] and AVPD
[8] databases, review outcomes and accuracy of 30
relevant articles and identify the gap for research in this
field. We concentrated mostly on the related research
papers with respect to these criteria in order to
understand the problem through machine learning or
implementation. This includes articles that mostly used
voice recordings from SVD [7], MEEI [8] and AVPD
[8] database to detect voice disorder. Research article
consisting of machine learning techniques. The articles
consists of voice filtering and segmentation techniques,
an application, or any software in order to detect the
disease through voices. All articles are in the language
of English.
In table 1, it has been noticed that SVM is the most
used algorithm for the identification of voice disorders
in all three datasets. In our lives today, the recognition
of voice disorders plays an important role. Many of
these disorders should therefore be treated until they
progress to a critical condition at an early stage of
incidence. SVMs have become a popular tool for
discriminatory labeling. Speech synthesis is a promising
field for recent SVM applications [11].
Feature selection Classifier Accuracy in %
MFCC SVM 99.53
99.54
96.01
MFCC GMM 80.02
94,6
83,6
SE, ZCR, SH SVM 95
GBR scale GMR --
PCA DLN 80
HOS, DWT SVM 99.3
2
7 Panek et al./2016 [18] SVD PCA K-means Clustering 100

8 Markaki et al./2009 [19] SVD Mutual Information b/w SVM 94.1

subjective voice quality and
computed features

9 Markaki et al./2011 [20] SVD mutual information p/w voice SVM 94.1
classes
(normophonic/dysphonic)

10 Miramont et al./2020 [21] SVD CPP, SDNPCV, NPCV, HNR SVM 86.53
MEEI ---
11 Muhammad etal. /2017 [22] SVD Glottal source excitation SVM 93.2
MEEI 99,4
AVPD 91,5
12 Kadiri et al./2020 [23] SVD Glottal source features and SVM 76.19
MFCC

13 Teixeira et al./2018 [24] SVD Jitter, shimmer and HNR, SVM 71

MFCC

14 Teixeira et al./2017 [25] SVD Jitter, shimmer and HNR MLP-ANN 95

15 Amami et al./2017 [26] MEEI DBSCAN and MFCCs SVM 98

16 Londono et al./2010 [27] MEEI MFCC HMM 82.14

17 Arjmandi et al./2011 [28] MEEI MDVP parameters QD, NM, KNN, 78.9
SVM, ML
18 Barreira et al./2020 [29] MEEI HASS-KLD, H-KLD, MFCC GNB 99.55

19 Cordeiro et al./2017 [30] MEEI MFCC, LSF SVM, GMM, DA 98.7

20 Cordeiro et al./2018 [31] MEEI RPPC SVM 94.2

21 Fang et al. /2019 [32] MEEI MFCC DNN, SVM, GMM 99.14

22 Llorente et al./2009 [33] MEEI MFCC MLP-ANN 96

23 Mahmood /2019 [34] MEEI MFCC ANN, SVM, RF 72.70

24 Muhammad et al. /2014 [35] MEEI MPEG-7 feature SVM 99.994

25 Ghulam Muhammad/2016 SVD MFCC SVM 87,85

[36] MEEI GMM 98,23
26 Lili Chen/2021 [37] VED II LPCC KNN 93.3
27 Laura Verdea/2021 [38] ENT HNR, jitter, Shimmer RF 83.3
28 Li Deng/2016 [39] TIMIT DNN derived features DNN 81.7
CNN
RNN
29 Mousumi Malakar/2021 MEEI HNR, jitter, Shimmer KNN 96.1
[40]
30 Alireza A. MEEI MFCC LDC GMM NMC 98.59
Dibazar/2002[41]

3
Support Vector Machine (SVM) is an old classification
approach and has shown great scientific interest,
especially in the fields of machine classification,
regression and learning. SVM with the known classes
associated. This is defined as filtering or extraction of
features. Even if no prediction of unknown samples is
necessary, function selection and SVM classification
have been used together. They may be used to define
main sets that take part in the class differentiation
process. Let’s take an example about the classification
of pathological and healthy voices the first is based on
MPEG-7 functionality to train and test an SVM
classifier. These got a good accuracy represented in
99.994% in [35], in this research, the database used in
MEEI it contains sustained vowel/AH/recordings by 53
normal speakers with duration of around 3 s and by 657
pathological speakers, with a wide variety of diseases,
with duration of around 1 second. A method was
developed in the seconde for short-time jitter and the
PCA reached 80% in [16]. Mel-frequency cepstral
coefficients (MFCC) are popular features in speech
analysis, and have been used also in voice pathology
detection. . The third one is [32], detection of
pathological voice was done by MFCC and SVM,
GMM and DNN classifiers reached an accuracy of
99.14%, this research was applied on a subset samples
from the Massachusetts Eye and Ear Infirmary (MEEI)
database [8].
In other study [27] used HMM classifier applied on
MEEI dataset and extract MFCC as feature give 82.14%
as accuracy.
2. MATERIALS AND METHODS:
2.1 The datasets:
The primary database that's utilized in this audit
is Saarbruecken Voice Database (SVD) [7]. A
collection of voice recordings by over 2000 individuals.
Vocal enlistment [I a, u] created at standard, tall and
moo pitches. Vocal documentation of expanding pitch
[I a, u]. Recording of the phrase'' Great morning, how
do you like it?''. The database has content record
incorporates all pertinent data almost the dataset. Those
characteristics make it a great choice for experimenters
to utilize. All recorded SVD voices were tested with a
determination of 16-bit at 50 kHz.
The second database that's utilized in this
survey is Massachusetts eye and ear hospital (MEEI)
[8]. Contains over 1,400 vocal tests of the long vowel /
a/ and the primary parcel of the Rainbow entry, made
by MEEI Voice and Discourse Lab. It has been sold in
two particular environment by Kay Elemetrics [42]. The
inspecting recurrence was 50 kHz. It is utilized in most
voice pathology discovery and classification tests in
spite of the fact that the distinctive conditions and sound
levels utilized to capture typical and obsessive voice
have numerous disadvantages. In this collection, a few
devices, such as stroboscopy, sound-related optimal
design and physical neck and mouth tests, were utilized
to survey discourse clutters (this data was given by Kay
Elemetrics).
The third database that's utilized in this audit is
Arabic voice pathology database (AVPD) [8]. Tests of
words and voices were recorded at different sessions in
Lord Abdul Aziz College Clinic in Riyadh, Saudi
Arabia, Communication & Gulping Disarranges Unit.
In a sound treatment room, a standard recording
protocol was utilized to gather voices of the quiet by
experienced phoneticists. The database convention has
been created to anticipate particular MEEI information
base lacks [43]. The AVPD gives records of long-
standing vowels and voice collapsing disarranges,
coupled with the same records of customary speakers.
2.2 Features used for classification:
Feature extraction is the primary step in any voice
clutter discovery framework. In this step, the given
voice signals are changed over into agent acoustic
highlights utilizing different digital signal handling
procedures. We'll presently talk about the foremost
prevalently utilized techniques for acoustic
investigation and highlight extraction within the related
region. We have chosen the most highlights utilized in
a few connected thinks about existing in writing
concerning the utilize of machine learning strategies for
the voice classification.
Mel-frequency cepstral coefficient: Mel-frequency
cepstral coefficient (MFCC) is a standard method for
feature extraction that makes use of the knowledge of
human auditory system. The general steps for extracting
the MFCC features for a single frame [44], [45] are as
follows:
i. Computation of the discrete Fourier transform
coefficients.
ii. Filtering with Mel spaced triangular filter.
iii. Computation of sub-band energies.
iv. Computation of the discrete cosine transform
coefficients.
Harmonic to Noise Ratio (HNR): this quantifies the
ratio of signal information over noise due to turbulent
airflow, resulting from an incomplete vocal fold closure
in speech pathologies.
Discrete wavelet transform: The discrete wavelet
transform (DWT) can be used in variety of signal
processing applications. It is discrete in time and scale.
The voice is a time variant signal and sometimes need
to be converted into frequency domain for the analysis.
DWT is capable of performing a joint time−frequency
analysis and also the analysis of high frequency
characteristics of the pathological voices. Hence, it is
useful tool for voice disorder detection. The DWT
4
coefficients may have real values, but the time and scale
values used to index these coefficients are integers. [46],
[47].
Jitter: this describes the instabilities of the oscillating
pattern of the vocal folds, quantifying the cycle-to-cycle
changes in fundamental frequency.
Shimmer: this indicates the instabilities of the
oscillating pattern of the vocal folds, quantifying the
cycle-to-cycle changes in amplitude.
The jitter and shimmer features, they were estimated
utilizing the method presented in [48].
Glottal flow signal parameters: The glottal flow
signal can be obtained by performing an inverse
filtering of the voice signal, which consists of
eliminating the influence of the vocal tract and the voice
radiation caused by the mouth, and preserving the
glottal flow signal characteristics.
Linear Predictive Coding: LPC and LPCC simulate
the vocal tract characteristics based on human speech
production model, whereas MFCC mimics the human
perception of hearing. Earlier, LPC and LPCC were
widely used as they are considered as easy to compute.
MDVP: the application of acoustic analysis in voice
disorder detection can be found in9 and Sonu,
Sharma.10 Multidimensional Voice Program (MDVP)
is standard software for acoustic analysis, and it is most
popularly used in AVDD systems. It is reliable and very
comprehensive. Using MDVP, one can estimate 33
voice parameters, which measure frequency related,
intensity related, noise related, tremor related, and its
perturbations measures among others.
2.3 Machine learning algorithms:
Different machine learning algorithms have been
selected by us. Actually, based on a set of shared
qualities, each of them has been selected as a
representative of a class of algorithms. These methods
include:
support vector machine (SVM): SVM is widely used
for data classification and it is known forits high
prediction capabilities in many signal processing
applica-tions [11]. SVM objective is to find the optimal
hyper plane that separates the two classes while
maximizing the margin between separating boundary
and the closest samples to it (support vec-tor).
HMM is used to model the spectral variability of each
speech sound using a mixture Gaussian distribution.
Hidden Markov Model (HMM): HMM acts as a
stochastic finite state machine, which is assumed to be
built from a finite set of possible states (hidden during
evaluation) and each of those states are associated with
a mixture of Gaussian probability density function.[49],
[50], [51]
Gaussian Mixture Model (GMM): GMM is used to
model the probability distribution of feature values,
which are continuous in nature. The voice acoustic
measures are continuous. Hence, it is suitable to model
the voice characteristics. GMM parameters are
estimated during training using
expectation−maximization iterative algorithm or
maximum a posteriori algorithm.
Convolutional neural network (CNN): is attracting
interest through a range of domains, including
radiology. CNN is designed to learn spatial hierarchies
through numerous building blocks, including cooling
layers, bonding layers and fully connected layers,
automatic and adaptive context propagation. [49]. CNN
is a deep learning method that is commonly used for
solving difficult problems. CNN is a deep learning
solution.
Artificial Neural Networks (ANN): ANN algorithm
works based on the concepts of biological neural
networks in human. It consists of set of neurons
connected to each other and the output of one neuron
can be fed as input to another neuron. The neurons are
arranged in layers, ie, input layer, hidden layer, and
output layer also referred as multilayer perceptron
(MLP) where the number of neurons in each layer and
the total numbers of layers depend on the type of
applications.
Deep Neural Network (DNN): DNN is basically a feed
forward network having more layers, hence is more
powerful than the traditional ANN. A special attraction
of DNN is the bottleneck layer which typically consists
of fewer nodes compared to previous layer. This layer
produces an abstract representation of incoming
information by compressing it. At an extreme, DNN can
be used to develop an end-to-end ASR system
successfully. [52]
Decision Tree (DT): this technique is used to classify
categorical data in which the learned function is
represented by a decision tree. Decision trees are easy
to interpret, capable of working with missing values and
categorical and continuous data, characteristics of the
medical field. We have used J48, an implementation of
algorithm C4.5 [53], the most popular tree classifier.
It is important to remark here that other classification
techniques are not reported in this study due to the poor
performance achieved during our experiments.
5
 3. RESULTS AND DISCUSSION:
In this section, we are going to discuss the strengths and
weaknesses of SVD, MEEI and AVPD. After detailed
analysis of the studies including the techniques used and
outcome measurements. As we notice previously the
performance of the selected machine learning
classification techniques was assessed as far as
accuracy, sensibility and specificity. The accuracy, that
is the percentage of correctly classified instances, is
defined as:
(𝑇𝑃 + 𝑇𝑁)
𝐴𝑐𝑐𝑢𝑟𝑎𝑐𝑦 =
(𝑇𝑃 + 𝑇𝑁 + 𝐹𝑃 + 𝐹𝑁)
While the sensitivity and the specificity that represent
respectively the test’s ability to detect positive results or
the identification of negative results, are defined as:
𝑇𝑃
Sensitivity =
(𝑇𝑃 + 𝐹𝑁)
𝑇𝑁
Specificity =
(𝑇𝑁 + 𝐹𝑃)
o True Positive (TP): the voice sample is pathological
and the algorithm recognizes this;
o True Negative (TN): the voice sample is healthy
and the algorithm recognizes this;
o False Positive (FP): the voice sample is healthy but
the algorithm recognizes it as pathological;
o False Negative (FN): the voice sample is
pathological but the algorithm recognizes it as
healthy.
3.1 Results
In our study, we have chosen to test the machine
learning classification techniques over the overall
database, and, additionally, over three different
databases chosen by selecting some of the calculated the
features selected applying the SVM.
A quantitative analysis has been done that shows that
significance of SVM in figure 1, 2 and 3. SVM is the
algorithm that has been widely used in the detection of
voice disorders. For many years SVM and its
application in the area of medical has been the topic of
research for many researchers. SVM is the preference
of scientist as a machine-learning algorithm because of
its best accuracy outcomes. In figure 1, 2 and 3 it has
been observed that with variation in features different
accuracies has been evaluated with SVM as a common
algorithm in SVD [7], MEEI [8] and AVPD [8]
database. The features with the best accuracy are
MDVP, MPEG-7 and MFCC in the three datasets
respectively. However, generally all the extracted
features are good because the accuracy of each of them
is greater than 50% except the VTAI feature in MEEI
dataset.

jitter shimmer hnr mfcc [23] 71

Glottal source features and MFCC [22] 76,19
Glottal source excitation [21] 93,2
CPP, SDNPCV, NPCV, HNR, NOICE LEVEL, D2, Shimmer ,K2 [20] 86,53
mutual informaton b/w voice classes [19] 94,1
glottal flow features [58] 98,43
HOS, DWT [16] 99,35
SE, ZCRs, SH [13] 95
eight frequency band [57] 90,9
MDVP [60] 99,68
peak, lag, entropy [11] 99,53

0 10 20 30 40 50 60 70 80 90 100

Accuracy

Figure 1:Bar graph representing overall accuracy of SVM algorithm used in SVD with different features.

6
 nonliear dynamic parameterization [39] 96,73
parametric wavelet y adaptation wavelet transform [36] 98,3
Glottal source excitation [21] 99,4
MPEG-7 feature [34] 99,99
CPP, SDNPCV, NPCV, HNR, NOICE LEVEL, D2, Shimmer ,K2 [20] 87,06
spectra, inferiorclliculus coefficients 99,9
glottal flow features [58] 93,57
wavelet packet transform based energy/entropy [59] 92,24
VTAI feature [8] 0
MPEG-7 low level audio feature [54] 99,99
RPPC [55] 94,2
MFCC LSF [29] 98,7
eight frequency band [57] 99,8
MDVP |60] 88,21
peak, lag, entropy [11] 99,54
0 10 20 30 40 50 60 70 80 90 100

Accuracy in %

Figure 2: Bar graph representing overall accuracy of SVM algorithm used in MEEI with different features.

91,5
Glottal source excitation [21]

93,6
MFCC [56]

91,6
eight frequency bands using correlation functions [57]

72,53
MDVP [60]

96,02
peak, lag, entropy [11]

0 10 20 30 40 50 60 70 80 90 100

Accuracy in %

Figure 3: Bar graph representing overall accuracy of SVM algorithm used in AVPD with different features.

A quantitative analysis has been done between other
algorithms in all selected databases that shows in figure
4, 5 and 6. It has been observed that other than SVM,
there are some algorithms that are resulted in good
accuracies. For example, in SVD, Zulfiqar Ali et al.
[12], GMM is used and the resulted accuracy is 80.02%
with sensitivity 91.22% and specificity 94.27%. A
Gaussian mixture model (GMM), as a weighted sum of
Gaussian elements, is a parametric probability density
function. GMMs are commonly used as a parametric
model to distribute the probability in continuous
measurements or characteristics in a biometry system,
such as spectral related vocal-tract characteristics in a
speech recognition system. The GMM parameters can
be estimated from training data based on a well-
qualified pre-model iterative EM or Maximum
Posteriori (MAP) estimation [63]. In Moon et al. [61],
Random Forest algorithm is used to detect voice
disorders and the resulted outcome is 84.87% accuracy
however overall sensitivity and specificity were not
reported. RF is a series or community of classification
trees and regression trees [68] which is trained in
datasets of the same scale as the training set, called
bootstraps. Once a tree is developed, bootstraps are used
7
as test set which do not contain any specific record of
the original (out - of-bag (OOB)) samples. The OOB
estimate of the generalization error is the error rate of
classification in all test sets. In 1996 [64] Breiman found
that an OOB mistake is correct with a test set of the
same size as that for the bagged classifiers. It removes
the need for a different test set with the OOB
calculation. In SVD, the highest reported accuracy of is
99% [60]. After SVM, GMM [12,14] and RT [58],
convolutional neural network used in the detection of
voice disorder and resulted in good outcome. A class
that is influential in various computer vision tasks,
Convolutional neural network (CNN) is attracting
interest through a range of domains, including
radiology. CNN is designed to learn spatial hierarchies
through numerous building blocks, including cooling
layers, bonding layers and fully connected layers,
automatic and adaptive context propagation. [65]. CNN
is a deep learning method that is commonly used for
solving difficult problems. CNN is a deep learning
solution. This overcomes the limitations of traditional
machines [66]. In [15] CNN is used and the reported
accuracy is 78%.

100 94,23
91,22 100 99,27 93,3 100
84,4 87,4
90 80,02 82,77 80,25
787880
80
70
60
50
40
30
20
10 000 00
0

Accuracy Sensitivity Specificity

Figure 4: Bar graph representing overall accuracy of multiple algorithms used in SVD.

100 94,6 99,4 96,67 99,55

93,6
88,86 89,82 89,54
87,2 86,97
90 82,14
78,9
80
70
60
50
40
30
20
10
0
GMM ANN HMM LDA and HMM QD NM KNN Naive KNN PNN cart [59]
[12] [58] [34] NN [35] [25] classifier classifier classifier bayes [59] [59]
[27] [27] [27] [28]

Accuracy Sensitivity specificity

Figure 5: Bar graph representing overall accuracy of multiple algorithms used in MEEI.

8
 100
89.74% 90.30%
90 83.60%
78.40%
80
70
60
50
40
30
20
10
0
GMM [12] VQ [40]
Accuracy
Figure 6 :Bar graph representing overall accuracy of multiple algorithms used in AVPD.
In figure 5 of MEEI, Naïve Bayes [28] has the lowest
reported accuracy which is 72.70%. Other than Naïve
Bayes, algorithms like HMM [34,25], LDA [35], GMM
[12], RF [61], PNN [59], KNN [59], ANN [58] all have
accuracies ranging in between 90% to 100%, which is
again considered as the good reported outcome in terms
of accuracy.
In AVPD, all the algorithms used GMM [12], GMM
[40], VQ [40] and HMM [40] all have accuracies bigger
than 83% which is again considered as the good
reported outcome in terms of accuracy.
3.2 Discussion:
We notice that the quantitative analysis it used only one
unsupervised technique and that is only in SVD in
Panek et al. /2016 [17] , its resulted accuracy is increase
to 99% with no sensitivity and specificity. Other than
there is not a researcher that use any unsupervised
technique for voice pathology detection. The validation
of PCA by k-mean clustering and cross validation loses
10% signal (the variance of 90%) from the initial vector
of the feature and produces worse results than the
analysis by the original 28 vectors of functionality.
In comparison with the results for the analysis based on
kPCA included all the pitches analyzed showed the
most accurate evidence of patient's health and
condition. The analogous analysis of records showed
100 % accuracy for 28 feature vectors and for the
91.60%
88.90%
GMM [40] HMM [40]
Sensitivity Specificity
relevant number of key components for each pitch and
kPCA result for each vowel.
The k-means algorithm provides perfect separation of
data for male recordings, which is the opposite of the
female analysis using 28 parameters and PCA. This
question was coped to and 99% of the classification
accuracy from the kPCA analytics, which are non-linear
data transformation. This indicates that the isolation of
data in linear fashion was not adequate. In addition, k-
means algorithm is presented as artifacts allocated by
distance to the closest cluster. [17], though it is been
suggested that researchers should focus more
unsupervised techniques and evaluate these databases.
Tissue diseases, systemic changes, mechanical stress,
surface discomfort, change in tissue, changes in
neurology and muscle, and other factors [59] can cause
Voice disease. The agility, strength and form of Vocal
folds, resulting in abnormal noise and reduced acoustic
tone, was affected by the vocal pathology. Subjective
and objective evaluations of vocal problems have been
approached until now [67]. The first group (subjective
assessment) is the auditory and visual analysis of vocal
folds in a hospital [68]. The first is a subjective
assessment. The second category (target evaluation) is
focused on automatic computer-based processing of
acoustic signals to measure and identify the underlying
vocal pathology, which may not even be detected by a
human [40]. Therefore, this type of assessment is
inherently non-subjective. Within reality, voices can
now easily be captured and stored globally via cloud
technologies using many intelligent devices. Many
libraries have been commonly used by researchers for
9
the objective assessment of speech pathology. The
Massachusetts Eye and Ear Infirmary (MEEI) [8], the
Saarbrücken Voice Database (SVD) [7], and the Arabic
Voice Pathology Database (AVPD) [8]. In the
repositories there are also some pitfalls. For example,
certain bases are highly uniformly distributed within
stable and unhealthy groups, and datasets provide
troubling differences in the number of samples per type
of pathology (e.g. there are fewer than 3 as more
pathologies in the database). Some repositories do not
have details on the severity of disease or on pathology
symptoms during phonation, so some of the samples
may seem safe, despite being called pathology and vice
versa. Not to mention that more than 1 type of pathology
is used to label documents and it is particularly
challenging to incorporate or delete samples in different
language [68].
Talking about the limitation of this systematic review,
we cannot deny the fact of lower number of included
publications. Secondly those articles were selected
which were published in English language, which can
restrict the portrayal of work from non-English
speaking countries and limit the generalizability of the
results. Thirdly, there's a big possibility that search
strategy for this review may have missed some relevant
studies, since the studies which were published in
conference proceedings were avoided mostly.
4. CONCLUSIONS:
In recent years, the use of mobile multimedia services
and applications in healthcare sector has been
increasing significantly. Mobile health applications
allow people to access medical information and data of
interest at any time and anywhere, useful for the
monitoring and detection of specific diseases, such as
dysphonia, a voice disorder often underestimated that
affects a great percentage of people.
Research on mobile automatic systems to estimate voice
disorders has received considerable attention in the last
few years due to its objectivity and non-invasive nature.
Machine learning techniques can be a valid support to
investigate new approaches to signal processing in an
easy and fast way that can be implemented in an m-
health solution. This study compares the performance of
different voice pathology identification methods, taking
into account the main machine learning techniques.
Moreover, in this work we focus on identifying
appropriate voice signal features by using the
comparative study of different classifiers. All analyses
are performed on a wide dataset of voices selected from
the Saarbruecken Voice Database.
The tests have been carried out over the overall dataset
and over three different subset where we only have
considered the selected features by three specific
features selection methods. The results have shown that
the best accuracy in voice pathology detection is
achieved using the Support Vector Machine algorithm.
This technique classifies a voice as pathological or
healthy with an accuracy equal to about 86% using all
parameters. Result confirmed observing the
experimental tests in which the InfoGainAttribute
Eval method and PCA one have been applied (accuracy
values were, respectively, equal to 84.16% and
71.75%). Meanwhile, when we only considered
parameters selected with the Correlation method, the
best accuracy was obtained with the Decision Tree
technique.
Although the accuracy values are smaller than the
values obtained in other studies in literature, it is
necessary to highlight that all these studies are
performed on very limited and, often, non-accessible
datasets. To enhance the classification rate obtained we
are interested in improving the classification phase by
developing a hybrid system using a combination of
several machine-learning techniques.
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