Abstract
Pain is an internal construct with vocal manifestation that varies as a function of personal and clinical attributes. Understanding the vocal indicators of pain-levels is important in providing an objective analytic in clinical assessment and intervention. In this work, we focus on investigating the variability of voice quality as a function of multiple clinical parameters at different pain-levels, specifically for emergency room patients during triage. Their pain-induced pathological voice quality characteristics are naturally affected by an individual attributes such as age, gender and pain-sites. We conduct a detailed multivariate statistical analysis on a 181 unique patient's vocal quality using recordings of real triage sessions. Our analysis show several important insights, 1) voice quality only varies statistically with pain-levels when interacting effect from other clinical parameters is considered, 2) senior group shows a higher value of voicing probability and shimmer when experiencing severe pain, 3) patients with abdomen pain have a lower jitter and shimmer during severe pain that is different from patients experiencing musculoskeletal pathology, and 4) there could be a relationship between the variation in the voice quality and the neural pathway of pain as evident by interacting with the pain-site factor.