New research suggests acoustic speech features can identify respiratory exacerbations from the first day of onset.
RT’s Three Key Takeaways:
- Voice Biomarkers: Researchers found that 13 acoustic speech features changed significantly on the first day of a respiratory exacerbation, often before symptoms reached their peak.
- Feasibility of Monitoring: Study participants completed mobile-based voice recording tasks on 83% of intended days, demonstrating the potential for high compliance in digital healthcare monitoring.
- Clinical Implementation: While the associations between voice and airway obstruction are promising, the researchers concluded that predictive algorithms must be developed before the technology is integrated into clinical care.
Changes in a patient’s voice may identify asthma and COPD exacerbations starting on the first day, potentially supporting future remote monitoring, according to the TACTICAS study.
Researchers found that several acoustic speech features changed at the onset of an exacerbation, before symptoms reached their peak. The findings suggest that a voice biomarker could eventually provide a simple digital method for monitoring people with chronic respiratory disease at home, according to data published in ERJ Open Research.
The prospective study included 73 Dutch-speaking participants, comprising 35 people with asthma and 38 with COPD. The mean age of the participants was 62 years.
Participants completed daily voice recordings on their own mobile devices for approximately 3 months. Tasks included sustaining an “a” vowel and reading text. Investigators tracked exacerbation onset, peak symptom burden, and recovery using respiratory symptom questionnaires, electronic healthcare records, medication use, and participant-reported symptoms.
The investigators analyzed 39 speech features and collected 23,799 recordings, including 2,737 during exacerbation periods. Throughout the study, 38 exacerbations occurred among 35 participants, including 16 mild, 19 moderate, and three severe cases.
Thirteen voice features changed significantly on the first day of an exacerbation. Sustained vowel duration decreased, while measures reflecting irregular vocal fold vibration and reduced voice quality increased. Changes were also observed in pitch, pulses, periods, jitter, shimmer, and the balance between harmonic sound and noise.
Breathlessness and chest symptoms showed stronger associations with speech features than cough and sputum symptoms. The effects did not differ significantly between asthma and COPD, suggesting that acute airway obstruction may contribute to similar vocal changes across both conditions, the researchers said.
Participants completed at least one speech task on 83% of intended study days, supporting the feasibility of mobile voice monitoring. However, the observed effects were small, and the analysis identified associations rather than demonstrating that voice could predict exacerbations. The study was also limited to Dutch speakers and requires validation in larger, multilingual populations.
The researchers concluded that a voice biomarker may eventually support earlier identification and management of respiratory deterioration, although predictive algorithms and integration into clinical healthcare pathways remain necessary.
Reference
van Bemmel L et al. Voice as biomarker for early exacerbation detection in asthma and COPD: the TACTICAS study. ERJ Open Res. 2026. doi:10.1183/23120541.01737-2025.
This article was originally published by AMJ and was made available under the terms of the Creative Commons Attribution-Non Commercial 4.0 License.
