Voices offer lots of information. Turns out, they can even help diagnose an illness — and researchers are working on an app for that.

The National Institutes of Health is funding a massive research project to collect voice data and develop an AI that could diagnose people based on their speech.

Everything from your vocal cord vibrations to breathing patterns when you speak offers potential information about your health, says laryngologist Dr. Yael Bensoussan, the director of the University of South Florida's Health Voice Center and a leader on the study.

"We asked experts: Well, if you close your eyes when a patient comes in, just by listening to their voice, can you have an idea of the diagnosis they have?" Bensoussan says. "And that's where we got all our information."

Someone who speaks low and slowly might have Parkinson's disease. Slurring is a sign of a stroke. Scientists could even diagnose depression or cancer. The team will start by collecting the voices of people with conditions in five areas: neurological disorders, voice disorders, mood disorders, respiratory disorders and pediatric disorders like autism and speech delays.

The project is part of the NIH's Bridge to AI program, which launched over a year ago with more than $100 million in funding from the federal government, with the goal of creating large-scale health care databases for precision medicine.

"We were really lacking large what we call open source databases," Bensoussan says. "Every institution kind of has their own database of data. But to create these networks and these infrastructures was really important to then allow researchers from other generations to use this data."

This isn't the first time researchers have used AI to study human voices, but it's the first time data will be collected on this level — the project is a collaboration between USF, Cornell and 10 other institutions.

"We saw that everybody was kind of doing very similar work but always at a smaller level," Bensoussan says. "We needed to do something as a team and build a network."

The ultimate goal is an app that could help bridge access to rural or underserved communities, by helping general practitioners refer patients to specialists. Long term, iPhones or Alexa could detect changes in your voice, such as a cough, and advise you to seek medical attention.

To get there, researchers have to start by amassing data, since the AI can only get as good as the database it's learning from. By the end of the four years, they hope to collect about 30,000 voices, with data on other biomarkers — like clinical data and genetic information — to match.

Parkinson's disease

"We really want to build something scalable," Bensoussan says, "because if we can only collect data in our acoustic laboratories and people have to come to an academic institution to do that, then it kind of defeats the purpose."

Glottic Cancer

Vocal Fold Paralysis

There are a few roadblocks. HIPAA — the law that regulates medical privacy — isn't really clear on whether researchers can share voices.

"Let's say you donate your voice to our project," says Yael Bensoussan. "Who does the voice belong to? What are we allowed to do with it? What are researchers allowed to do with it? Can it be commercialized?"

While other health data can be separated from a patient's identity and used for research, voices are often identifiable. Every institution has different rules on what can be shared, and that opens all sorts of ethical and legal questions a team of bioethicists will explore.

In the meantime, here are three voice samples that can be shared:

Credit to SpeechVive, via YouTube.

The latter two clips come from the Perceptual Voice Qualities Database(PVQD), whose license can be found here. No changes were made to the audio.
Copyright 2022 NPR. To see more, visit https://www.npr.org.

Updated at 1:40 p.m. ET

Dr. Anthony Fauci, the country's top infectious disease expert, told members of Congress Tuesday that although he can't predict the ultimate number of infections and deaths related to the coronavirus, "it's going to be very disturbing."

"When you have an outbreak in one part of the country, even though in other parts of the country they're doing well, they are vulnerable," he said. "We can't just focus on those areas that are having the surge. It puts the entire country at risk. We are now having 40-plus thousand new cases a day. I would not be surprised if we go up to 100,000 a day if this does not turn around," he told the Senate Committee on Health, Education, Labor and Pensions, which convened to discuss plans for reopening schools and work offices that have been shuttered by the deadly coronavirus pandemic.

Drs. Robert Redfield, Director of the Centers for Disease Control and Prevention, Stephen Hahn, Food and Drug Administration commissioner, and Adm. Brett Giroir, assistant secretary for health at the Department of Health and Human Services, also testified.

Masks still front and center

Committee Chairman Lamar Alexander, R-Tenn., urged people to take CDC guidelines to wear a face covering seriously and lamented the politicization of mask-wearing.

"Unfortunately, this simple life-saving practice has become part of the political debate that says if you're for Trump, you don't wear a mask, if you're against Trump, you do," Alexander said. "That's why I've suggested that the president occasionally wear a mask, even though in most cases it's not necessary for him to do so. The president has plenty of admirers. They would follow his lead."

Sen. Bernie Sanders, I-Vt., asked the panel if they would support an effort to increase the production of masks in this country and distribute them free of charge.

"There's no doubt that wearing masks protects you," Dr. Fauci said. "Anything that furthers the use of masks, whether it's giving out free masks or any other mechanism, I am thoroughly in favor of."

Redfield concurred, calling universal mask-wearing "the most important thing we can do."

Surges of cases

Fauci said it is clear that some parts of the country skipped over checkpoints or guidelines for when it is safe to reopen. He added that even in states that followed the rules, it appears people are taking an "all or nothing approach" when it comes to social distancing and wearing face masks.

"Either be locked down or you see people in bars, not wearing masks, not avoiding crowds, not paying attention to physical distancing," Fauci described. "I think we need to emphasize the responsibility we have both as individuals and as part of a societal effort to ending the epidemic."

Giroir echoed that sentiment, saying he's concerned about the recent data from several states that indicate a rise in infections and an uptick in hospitalizations.

"We can reverse these concerning trends, if we work together," Giroir said. "We must take personal responsibility and be disciplined about our own behavior. Maintain physical distancing, wear a face covering whenever you can't physically distance, wash your hands stay at home if you feel sick."

Vaccine

Regarding a potential vaccine, Fauci said that while health officials are hopeful, there's "no guarantee" the U.S. will develop a "safe and effective" vaccine for the coronavirus.

"But we are cautiously optimistic, looking at animal data and the early preliminary data, that we will at least know the extent of efficacy sometime in the winter and early part of next year ... Hopefully there will be doses available by the beginning of next year," he said.

Fauci also said that questions remain on how long someone who received a vaccination would retain immunity and that the "durability" of immunity could influence how often someone would need to receive an updated vaccine.

The panel also addressed the skepticism that still remains within the country over the safety of a vaccine.

"Public confidence in vaccines is so important," Redfield said. "We have an obligation to use all of our scientific knowledge, our regulatory framework to ensure that any vaccine that comes before us, whether for authorization or approval, meets our stringent standards for safety and effectiveness.

Reopening schools

Fauci told Sen. Rand Paul, R-Ky., that local officials should make the decision to reopen schools based on the prevalence of the virus in their district.

"I feel very strongly we need to do whatever we can to get the children back to school. So I think we are in locked agreement with that."

He suggested that there could be "creative" measures to modify a school's schedule and structure to allow for a reopening of some kind to occur.

Treatment

Hahn said he was optimistic about possible treatments for coronavirus for adults by the fall.

He noted that Remdesivir, an antiviral medication, has shown a reduction in hospitalization days among COVID-19 patients.

"Convalescent plasma, we have evaluated the safety through a large expanded access program at the Mayo Clinic and it's been found to be safe, and over 20,000 patients who administered it," Hahn said.

"That antibody data will help us in terms of the development of monoclonal antibodies," he described.

"Monoclonal antibodies are synthetic antibodies that the theory is will provide protection against the infection of the virus, and we're hopeful that those studies by the late summer, early fall will provide us information about their effectiveness and safety," Hahn explained.

Airlines

Redfield said there was "substantial disappointment" with the recent announcement that American Airlines plans to begin booking flights to full capacity. Redfield did not commit to any action when asked by Sen. Sanders if the federal government plans to impose guidelines or requirements for social distancing on airlines or buses.

"I can say this is under critical review by us at CDC," Redfield said. "We don't think it's the right message... Again, we think its really important that individuals that are in whether its a bus or a train or a plane are social distancing to the degree that it is feasible or at least have a reliable face covering."

The hearing comes as cases of the deadly respiratory virus have spiked across the United States, following calls from President Trump for states to reopen their economies and phase back into normal operations, despite health experts' guidance.

The president himself has bucked conventional wisdom on slowing the spread of COVID-19, holding large in-person events as part of his reelection campaign.

So far, more than 125,000 people in the United States have died from coronavirus infections, according to the Centers for Disease Control and Prevention. The United States has some 2.5 million confirmed cases.
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