AUTHOR=Jenkins Phillip , Harrison Rylan , Bedrick Steven , Karstens Lisa ,  Bridge2AI-Voice Consortium , Hersh William , Bensoussan Yael , Elemento Olivier , Rameau Anais , Sigaras Alexandros , Ghosh Satrajit , Powell Maria , Ravitsky Vardit , Belisle-Pipon Jean Christophe , Dorr David , Payne Phillip , Johnson Alistair , Bahr Ruth , Bolser Donald , Rudzicz Frank , Lerner-Ellis Jordan , Jenkins Kathy , Awan Shaheen , Boyer Micah , Hersh William , Krussel Andrea , Bedrick Steven , Syed Toufeeq Ahmed , Toghranegar Jamie , Anibal James , Sutherland Duncan , Diaz-Ocampo Enrique , Silberhoz Elizabeth , Costello John , Gelbard Alexander , Vinson Kimberly , Neal Tempestt , Jayachandran Lochana , Ng Evan , Casalino Selina , Abdel-Aty Yassmeen , Hanna Karim , Zesiewicz Theresa , Moothedan Elijah , Evangelista Emily , Cruz Samantha Salvi , Zhao Robin , Ebraheem Mohamed , Newberry Karlee , Santiago Iris De , Eiseman Ellie , Rahman JM , Jo Stacy , Goldenberg Anna 

TITLE=Voice as a biomarker: exploratory analysis for benign and malignant vocal fold lesions

JOURNAL=Frontiers in Digital Health

VOLUME=Volume 7 - 2025

YEAR=2025

URL=https://www.frontiersin.org/journals/digital-health/articles/10.3389/fdgth.2025.1609811

DOI=10.3389/fdgth.2025.1609811

ISSN=2673-253X

ABSTRACT=Benign and malignant vocal fold lesions can alter voice quality and lead to significant morbidity or, in the case of malignancy, mortality. Early, noninvasive identification of these lesions using voice as a biomarker may improve diagnostic access and outcomes. In this study, we analyzed data from the initial release of the Bridge2AI-Voice dataset to evaluate which acoustic features best distinguish laryngeal cancer and benign vocal fold lesions from other vocal pathologies and healthy voice function. Seven diagnostic cohorts were grouped into two analyses: the first included participants with laryngeal cancer, benign lesions, or no voice disorder; the second included those with laryngeal cancer or benign lesions without other voice disorders, as well as individuals with spasmodic dysphonia or vocal fold paralysis. Acoustic features including fundamental frequency, jitter, shimmer, and harmonic-to-noise ratio (HNR) were extracted from standardized speech recordings and compared using nonparametric statistical methods. Among the overall sample, significant differences were identified in HNR and fundamental frequency between benign lesions and both healthy controls and laryngeal cancer. In cisgender men, these distinctions were also observed, particularly in HNR and its variability. No statistically significant differences were observed among cisgender women, likely due to the limited sample size. These findings suggest that HNR, particularly its variability, may hold promise as a voice-based marker for early detection and monitoring of vocal fold lesions. Further research with larger, more diverse populations is needed to refine these features and validate their clinical utility.