The Relationship Between the Acoustic Breathiness Index and Voice Handicap Index in Turkish Adults

To examine the association between the Acoustic Breathiness Index (ABI) and patient-reported voice-related handicap (VHI-30 total and subscales) in Turkish-speaking adults with and without voice disorders.

This prospective case-control study included 150 participants with voice disorders and 150 normophonic individuals. The ABI was calculated in Praat using concatenated voice samples of connected speech and sustained vowel. The VHI-30 was used to assess patient-perceived voice handicap. Pearson's correlation analysis was conducted to assess the association between ABI and VHI-30 scores, and as the data of n = 300 were not normally distributed, the Mann-Whitney U test was used for group comparisons.

ccccccccccccABI scores were significantly higher in the voice-disordered participants (study group) than in normophonic individuals (control group) (P < 0.001), whereas no significant gender effect on ABI results was observed (P = 0.283). The study group showed higher ABI values in both females (study vs control: 5.22 ± 1.37 vs 3.39 ± 0.89) and males (study vs control: 5.01 ± 1.60 vs 2.24 ± 1.11) compared with the control group (both P < 0.001). Significant between-group differences were observed for all VHI-30 subscales and the total score (all P < 0.001). ABI correlated moderately with the Physical (r = 0.53, R² = 0.28), Functional (r = 0.59, R² = 0.35), Emotional (r = 0.47, R² = 22) subscales, and the total score (r = 0.52, R² = 27) (all P < 0.001).

The moderate correlation between ABI and VHI-30 supports the clinical value of ABI as a complementary tool in voice assessment and further underscores that, given the inherently multidimensional nature of voice disorders, evaluation is best conducted within a multidimensional assessment battery that integrates objective acoustic indices, auditory-perceptual ratings, and patient-reported outcomes.