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This study rigorously isolates the acoustic signal for COPD screening from age-related confounders, demonstrating that valid diagnostic models can exist without relying on demographic proxies. By proving that non-age voice features retain predictive power while age-based models degrade under strict evaluation protocols, the research advances methodological standards for medical AI and speech processing.
Separating Voice from Age in COPD Screening
arXiv:2608.21599v1 Announce Type: cross Abstract: Voice has been proposed as a low-cost screening signal for chronic obstructive pulmonary disease (COPD). COPD is strongly age-associated and voice changes with age, thus such results admit a trivial alternative explanation. We re-evaluate a public sustained-phonation corpus ($1246$ recordings, $68$ participants) under a strictly participant-level protocol. We therefore evaluate on repeatedly drawn age-matched cohorts and report the discrimination achieved by the confounders themselves on those same cohorts. Where raw (unmodelled) age ($0.510$ $[0.469, 0.551]$) and raw gender ($0.479$) are both measured at chance, acoustic models excluding age retain ROC-AUC $0.717$ $[0.552, 0.859]$ and average precision $0.747$ $[0.581, 0.892]$ against a one-to-one baseline of $0.5$, whereas models containing age fall to $0.531$--$0.679$. The separation is reproduced by two further learners with fixed hyperparameters. Two findings have broader methodological implications: models trained with age transfer less effectively to an age-balanced target cohort than otherwise identical models trained without age, and fourteen classical voice-quality and perturbation measures achieve comparable discrimination to a $55$-dimensional combined representation. We conclude that a non-age acoustic signal is present, that confounding by recording conditions cannot be excluded from the released features, and that the evaluation protocol in standard use cannot distinguish these possibilities.
Abstract:Voice has been proposed as a low-cost screening signal for chronic obstructive pulmonary disease (COPD). COPD is strongly age-associated and voice changes with age, thus such results admit a trivial alternative explanation. We re-evaluate a public sustained-phonation corpus ($1246$ recordings, $68$ participants) under a strictly participant-level protocol. We therefore evaluate on repeatedly drawn age-matched cohorts and report the discrimination achieved by the confounders themselves on those same cohorts. Where raw (unmodelled) age ($0.510$ $[0.469, 0.551]$) and raw gender ($0.479$) are both measured at chance, acoustic models excluding age retain ROC-AUC $0.717$ $[0.552, 0.859]$ and average precision $0.747$ $[0.581, 0.892]$ against a one-to-one baseline of $0.5$, whereas models containing age fall to $0.531$--$0.679$. The separation is reproduced by two further learners with fixed hyperparameters. Two findings have broader methodological implications: models trained with age transfer less effectively to an age-balanced target cohort than otherwise identical models trained without age, and fourteen classical voice-quality and perturbation measures achieve comparable discrimination to a $55$-dimensional combined representation. We conclude that a non-age acoustic signal is present, that confounding by recording conditions cannot be excluded from the released features, and that the evaluation protocol in standard use cannot distinguish these possibilities.
Audio and Speech Processing (eess.AS); Machine Learning (cs.LG); Sound (cs.SD); Signal Processing (eess.SP)
arXiv:2608.21599 [eess.AS]
(or arXiv:2608.21599v1 [eess.AS] for this version)
https://doi.org/10.48550/arXiv.2608.21599 Focus to learn more arXiv-issued DOI via DataCite (pending registration)
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