Beware using telemedicine for voice and speech therapy

As a effect of the coronavirus pandemic, radical crossed the satellite person experienced however teleconferencing platforms similar Zoom assistance folks enactment connected—playing games with friends, hosting virtual weddings, and adjacent visiting a doctor. But erstwhile it comes to telemedicine, not each aesculapian attraction is easy translated to a distant format.

In a virtual world, voice therapy presents a unsocial situation due to the fact that clinicians indispensable trust connected acoustic recordings of dependable to measure the effectiveness of their treatments. But galore teleconferencing platforms distort sounds successful their efforts to destruct inheritance noise.

Boston University postgraduate researcher Hasini Weerathunge wanted to find retired if fashionable teleconferencing platforms utilized for telemedicine could seizure sounds accurately capable for clinicians to successfully dainty and measure patients with dependable and speech disorders. Weerathunge, a postgraduate pupil chap astatine BU's Rafik B. Hariri Institute for Computing and Computational Science & Engineering and a Ph.D. campaigner successful biomedical engineering, does probe successful the laboratory of Cara Stepp, a College of Health & Rehabilitation Sciences: Sargent College subordinate prof of speech, language, and proceeding sciences.

"Although the COVID-19 situation appears to beryllium waning, telepractice popularity is present to stay," Stepp says.

Weerathunge and Stepp teamed up with different BU researchers to enactment 5 antithetic HIPAA-compliant teleconferencing platforms to the test: Cisco Webex, Microsoft Teams, Doxy.me, VSee Messenger, and Zoom.

As the pandemic unfolded and lockdowns moved overmuch dependable and code therapy online, "there was nary statement among [voice and speech] clinicians [who were] trying to person to telepractice therapy, and we wanted to find the accuracy of the acoustic measures they tin get done telepractice," Weerathunge says.

Although dependable therapists had sometimes conducted telepractice sessions with patients earlier the pandemic, evaluations of the effectiveness of attraction were ever carried retired successful person. During that process, a diligent goes into the session and sits successful a soundproof booth outfitted for code recordings. The diligent repeats sustained vowel sounds, similar "aaa" oregon "ooo," oregon reads a abbreviated transition that reflects a wide assortment of sounds and rima movements successful the English language. The recordings of the patient's dependable are past evaluated by algorithms that measurement acoustic properties, including the acoustic correlates of perceived transportation and loudness of the voice.

In-person dependable evaluations came to halt, however, astatine the tallness of the COVID-19 pandemic. Voice evaluations moved to a virtual format, but until now, the accuracy of those valuation procedures done online has ne'er been examined.

In a soundproof room, the squad recorded dependable samples from 29 patients, aged 18 to 82, that had a assortment of code oregon dependable diagnoses. These recordings were past played backmost to researchers done an outer talker implicit the teleconferencing platforms, simulating telepractice conversations.

The squad rapidly learned that each platform has its ain audio enhancement algorithm that affects the prime of the sound. Zoom was the lone level that enabled users to crook disconnected these audio enhancement features, allowing the researchers to trial the platform's archetypal audio.

Despite the enhancements, the squad predicted the quality to measurement vocal cardinal frequence (pitch) and vocal strength (loudness) done teleconferencing platforms is not importantly affected.

But the researchers discovered that each the teleconferencing platforms did a mediocre occupation astatine capturing galore measurements needed for close and clinically meaningful dependable evaluations. Pitch varied importantly connected each the virtual platforms compared to the real-life recordings. This mightiness beryllium owed to internet connection oregon bandwidth issues that impact however and erstwhile sounds get transmitted done the platforms, the researchers say.

They besides recovered the dynamic scope of the vocal loudness measured implicit telepractice was precise antithetic from unrecorded recordings. "This was the biggest astonishment for us," Weerathunge says. The effect was adjacent existent for Zoom, wherever the researchers could crook disconnected the audio enhancements.

Overall, "Microsoft Teams performed the best, successful that each our dependable measures were the slightest affected successful that platform," Weerathunge says.

Because galore of the dependable metrics collected from virtual platforms had clinically important differences from those collected successful person, Weerathunge and the squad impulse caution for dependable and code therapists utilizing telepractice.

"This enactment is apt to person important interaction connected clinical practice, providing important accusation astir the effects of these telepractice platforms connected objective dependable evaluations," Stepp says.

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More information: Hasini R. Weerathunge et al, Accuracy of Acoustic Measures of Voice via Telepractice Videoconferencing Platforms, Journal of Speech, Language, and Hearing Research (2021). DOI: 10.1044/2021_JSLHR-20-00625