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Objective assessment of speech quality in patients treated for head and neck cancer

 

Introduction
Speech impairment often occurs in patients after treatment for head and neck cancer. Subjective assessment by perceptual ratings is the gold standard to assess speech quality in clinical practice. However, subjective assessment is prone to variety in judgment within and between raters. There is no standardized measurement protocol to investigate speech quality to collaborate between speech language pathologists in different hospitals. Objective analysis of speech quality may add to a multidimensional speech assessment protocol.

Objectives
The goal of this study is to investigate the feasibility and validity of objective speech analyses in relation to subjective ratings by speech pathologists and to patient reported speech outcome.

Method
Speech recordings of 51 patients (6 months after reconstructive surgery and postoperative radiotherapy for oral or oropharyngeal cancer) and of 18 control speakers were subjectively evaluated regarding intelligibility, nasal resonance, and articulation. Also patient reported speech outcome was used (EORTC H&N35 Speech subscale). A range of speech sounds (vowels and voiceless stop consonants) was taken into account. The objective speech quality assessment included an Artificial Neural Network (ANN) and acoustic-phonetic analyses, and voice analyses. The algorithm (ANN) was trained to recognize characteristics in speech; acoustic-phonetic measurements were used to measure the durations of speech sounds, voice onset time, and vowel dispersion. Objective speech parameters were compared to perceptual speech evaluation and patient reported outcome.

Results
Objective acoustic-phonetic analysis and artificial neural network analysis of speech of patients is feasible and contributes to further development of a speech assessment protocol. However, prediction of speech quality as evaluated by speech pathologists and by patients themselves was moderate. More research is needed and ongoing.

Cooperation
THis project involves close cooperation with the Dept of Otolaryngology / Head & Neck Surgery of VU University Medical Center and the Dept of Radiotherapy of UMCG in Groningen, and the Dept of Language and Speech Technology of Radboud University Nijmegen.

Marieke de Bruijn defended her PhD thesis on June 10, 2013, Vrije Universiteit Amsterdam: "Speech quality in oral or oropharyngeal cancer patients: the development and evaluation of objective speech assessment methods".

Funding
VU University Medical Center (VUmc) and Dutch Cancer Society (KWF Kankerbestrijding).

Staff
PhD student
M.J. de Bruijn, MA, Linguist-researcher, dpt. Otolaryngology-Head&Neck Surgery, VUmc.
Project leaders
Prof I.M. Verdonck-de Leeuw, PhD, Psychologist, Speech and Language Therapist, Linguïst, dpt. Otolaryngology-Head&Neck Surgery, VUmc.
Project members
L.F.M. ten Bosch, PhD, Researcher, Centre for Language and Speech Technology, Linguistics, Radboud University Nijmegen
Prof J.A.  Langendijk, PhD MD, Radiotherapist-oncologist, dpt. Radiotherapy, University Medical Center Groningen (UMCG)
Prof C.R. Leemans, PhD MD, Head & Neck Surgeon, ENT-specialist, dpt. Otolaryngology-Head&Neck Surgery, VUmc.
 

Questions?
For questions, please contact:
Prof. I.M. Verdonck - de Leeuw
E-mail: s.biemans@vumc.nl

 

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Niels Stensen Fellowship
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Key paper

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November 2, 2011: KWF / Alpe d'HuZes funds a grant for the development and evaluation of an online intervention for informal caregivers of cancer patients.

 

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October 28, 2011: www.oncokompas.nl is online!

 

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Team work

Our research projects are embedded in the two largest research institutes of VU University in Amsterdam: VUmc CCA-VICI (Cancer Center Amsterdam) www.vumc.nl/afdelingen/CCA-V-ICI/ and EMGO+ (Institute for Health and Care Research emgo.nl

We work closely with patients and their caregivers and with researchers and physicians at VU University and VU University Medical Center in Amsterdam and other research institutes and hospitals in the Netherlands and worldwide. Team work is crucial  improving research and translating results into clinical practice.

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