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Listening For Illness: Your Voice May Soon Help Detect Health Problems

Applying Artificial intelligence to vocal cues is increasingly being used to detect a range of illnesses from COVID-19 to asthma and even depression. But such technology also comes with serious ethical concerns.

photo of a man yelling with white paint in background

What's that you say?

Guillaume de Germain Unsplash
Benoît Georges

PARIS — Thanks to artificial intelligence (AI), your voice can already be used to dictate messages to your smartphone, give commands to your Bluetooth speakers, or chat with your car's dashboard. But soon, it may be able to evaluate the state of your health by detecting respiratory (asthma, COVID-19) or neurodegenerative illnesses. It could even pick up mental health struggles, such as depression or anxiety.

The concept is simple: every pathology that affects the lungs, the heart, the brain, the muscles, or the vocal cords can lead to voice modifications. By using digital tools to analyze a recording, it must be possible to detect vocal biomarkers, the same way vocal recognition algorithms learned to understand a spoken language based on millions of sound samples.

“This sector is booming, linked to the market’s increase of vocal apps, for interaction or marketing for example,” says Guy Fagherazzi, Director of the health precision department at Luxembourg Institute of Health (LIH), which pilots an international study of samples collection for health.

Hearing what the patient doesn't say

For five years, research and scientific studies on vocal biomarkers are multiplying, whether that is for the diagnostic (recording used to detect the presence of an illness) or for the follow-up of patients (repeated recordings are used to measure a pathology’s evolution or the efficiency of certain treatments).

We can hear what your patient doesn’t tell you

Many start-ups have already started developing smartphone apps or websites. In the U.S., Kintsugi already offers to professionals a mental health disorders detection tool with the slogan: “We can hear what your patient doesn’t tell you.”

Ellipsis Health also targets employers on their website by saying that “early detection and a better employee engagement […] lowers the costs related to absenteeism.” Their compatriot Sonde Health developed a smartphone app about mental health wellbeing that also allows them to collect more vocal samples. They also offer biomarkers for respiratory illnesses under license.

Limited data

Vocal Biomarkers also got the attention of major pharmaceutical groups: last September, Pfizer spent $116 million to acquire ResApp Health, an Australian company with a technology able to detect 92% of COVID-19 cases with a coughing recording. And the Canadian start-up Winterlight Labs, founded in 2015, works with Genentech (Roche group) to evaluate the development of Alzheimer’s illness.

The first studies on vocal biomarkers were led 30 years ago on Parkinson’s disease, which makes a perceptible change in the voice of most patients. “Research considerably accelerated these five last years […] they benefited from smartphones generalization that allowed us to record and transmit vocal data anywhere but also from the progress of audio signal analysis and AI,” says Guy Fagherazzi.

Since then, “the pandemic has played a huge role,” says the expert. Since early 2020, a lot of studies have been launched in different countries comparing the recordings of symptomatic and asymptomatic cases to detect the illness. But there is still a lot of work to demonstrate the validity of the work and the quality of the data. Most of the existing studies were made on specific populations, with limited samples and a lot of labs failed to reproduce the same results with a larger population.

Listen up

photo of a man talking into his smartphone

How am I doing?

Photo by Soundtrap on Unsplash

Ethical concerns

“A lot of of data bases are too small or do not suit the studied pathologies,” explains Vincent Martin, a researcher who just devoted his doctorate thesis to vocal biomarkers for drowsiness detection. "For example, the most used corpus to detect depression in the voice was recorded with veterans suffering from post-traumatic symptoms.” A trained model on this sample will present a high error score if applied to the general population.

The use of vocal biomarkers will have to go through the the medical community and earn the patient’s trust. Its backers will have to clearly explain the benefits (high-speed, non-invasive, early diagnostic, online checkups) while guaranteeing the confidentiality and transparency of the tools.

The biggest fear is that, like facial recognition, digital tools detecting vocal biomarkers could be used without users' permission, which is concerning for technologies that are supposed to evaluate physical and mental health.

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