{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T13:26:08Z","timestamp":1789997168573,"version":"4.0.1"},"reference-count":25,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"7","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2020,4,9]]},"abstract":"<jats:sec xml:lang=\"en\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p xml:lang=\"en\">\n                      The purpose of this article is to evaluate the association of voice signal analysis with adverse outcome among patients with congestive heart failure (\n                      <jats:styled-content style=\"fixed-case\">CHF<\/jats:styled-content>\n                      ).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Methods and Results<\/jats:title>\n                    <jats:p xml:lang=\"en\">\n                      The study cohort included 10\u00a0583 patients who were registered to a call center of patients who had chronic conditions including\n                      <jats:styled-content style=\"fixed-case\">CHF<\/jats:styled-content>\n                      in Israel between 2013 and 2018. A total of 223 acoustic features were extracted from 20\u00a0s of speech for each patient. A biomarker was developed based on a training cohort of non\u2010\n                      <jats:styled-content style=\"fixed-case\">CHF<\/jats:styled-content>\n                      patients (N=8316). The biomarker was tested on a mutually exclusive\n                      <jats:styled-content style=\"fixed-case\">CHF<\/jats:styled-content>\n                      study cohort (N=2267) and was evaluated as a continuous and ordinal (4 quartiles) variable. Median age of the\n                      <jats:styled-content style=\"fixed-case\">CHF<\/jats:styled-content>\n                      study population was 77 (interquartile range 68\u201383) and 63% were men. During a median follow\u2010up of 20\u00a0months (interquartile range 9\u201334), 824 (36%) patients died. Kaplan\u2013Meier survival analysis showed higher cumulative probability of death with increasing quartiles (23%, 29%, 38%, and 54%;\n                      <jats:italic>P<\/jats:italic>\n                      &lt;0.001). Survival analysis with adjustment to known predictors of poor survival demonstrated that each SD increase in the biomarker was associated with a significant 32% increased risk of death during follow\u2010up (95% CI, 1.24\u20131.41,\n                      <jats:italic>P<\/jats:italic>\n                      &lt;0.001) and that compared with the lowest quartile, patients in the highest quartile were 96% more likely to die (95%\n                      <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>\n                      , 1.59\u20132.42,\n                      <jats:italic>P<\/jats:italic>\n                      &lt;0.001). The model consistently demonstrated an independent association of the biomarker with hospitalizations during follow\u2010up (\n                      <jats:italic>P<\/jats:italic>\n                      &lt;0.001).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p xml:lang=\"en\">\n                      Noninvasive vocal biomarker is associated with adverse outcome among\n                      <jats:styled-content style=\"fixed-case\">CHF<\/jats:styled-content>\n                      patients, suggesting a possible role for voice analysis in telemedicine and\n                      <jats:styled-content style=\"fixed-case\">CHF<\/jats:styled-content>\n                      patient care.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/jaha.119.013359","type":"journal-article","created":{"date-parts":[[2020,4,1]],"date-time":"2020-04-01T05:00:34Z","timestamp":1585717234000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":69,"title":["Vocal Biomarker Is Associated With Hospitalization and Mortality Among Heart Failure Patients"],"prefix":"10.1161","volume":"9","author":[{"given":"Elad","family":"Maor","sequence":"first","affiliation":[{"name":"Chaim Sheba Medical Center Tel Hashomer Israel"},{"name":"Sackler School of Medicine Tel Aviv University Tel Aviv Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniella","family":"Perry","sequence":"additional","affiliation":[{"name":"Vocalis Health Tel Aviv Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dana","family":"Mevorach","sequence":"additional","affiliation":[{"name":"Vocalis Health Tel Aviv Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nimrod","family":"Taiblum","sequence":"additional","affiliation":[{"name":"Vocalis Health Tel Aviv Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yotam","family":"Luz","sequence":"additional","affiliation":[{"name":"Vocalis Health Tel Aviv Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Israel","family":"Mazin","sequence":"additional","affiliation":[{"name":"Chaim Sheba Medical Center Tel Hashomer Israel"},{"name":"Sackler School of Medicine Tel Aviv University Tel Aviv Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amir","family":"Lerman","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Disease Mayo Clinic Rochester MN"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gideon","family":"Koren","sequence":"additional","affiliation":[{"name":"Kahn\u2010Maccabi Institute of Research and Innovation Tel Aviv Israel"},{"name":"Sackler School of Medicine Tel Aviv University Tel Aviv Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Varda","family":"Shalev","sequence":"additional","affiliation":[{"name":"Kahn\u2010Maccabi Institute of Research and Innovation Tel Aviv Israel"},{"name":"Sackler School of Medicine Tel Aviv University Tel Aviv Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(11)61229-4"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1010029"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD007228.pub3."},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.111.043042"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijcard.2017.10.099"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(14)61176-4"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(11)60101-3"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2017.03.009"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2013.01.052"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.mayocp.2017.12.025"},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.5334\/ijic.3320"},{"key":"e_1_3_2_13_2","volume-title":"Theory and Applications of Digital Speech Processing","author":"Rabiner L","year":"2010","unstructured":"Rabiner L, Schafer R. 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