Speech as a Biomarker: Opportunities, Interpretability, and Challenges
Abstract
Purpose: Over the past decade, the signal processing and machine learning literature has demonstrated notable advancements in automated speech processing with the use of artificial intelligence for medical assessment and monitoring (e.g., depression, dementia, and Parkinson's disease, among others). Meanwhile, the clinical speech literature has identified several interpretable, theoretically motivated measures that are sensitive to abnormalities in the cognitive, linguistic, affective, motoric, and anatomical domains. Both fields have, thus, independently demonstrated the potential for speech to serve as an informative biomarker for detecting different psychiatric and physiological conditions. However, despite these parallel advancements, automated speech biomarkers have not been integrated into routine clinical practice to date. Conclusions: In this article, we present opportunities and challenges for adoption of speech as a biomarker in clinical practice and research. Toward clinical acceptance and adoption of speech-based digital biomarkers, we argue for the importance of several factors such as robustness, specificity, diversity, and physiological interpretability of speech analytics in clinical applications.
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Clinical AI can be well suited to assessing or monitoring an individual's specific speech and language abilities, after the diagnostics have been considered by a human clinician in the loop.
“In contrast, clinical AI can indeed be well suited to assessing or monitoring an individual's specific speech and language abilities, after the diagnostics have been considered by a human clinician in the loop (e.g., Liss & Berisha, 2024;Ramanarayanan et al., 2022).”
From Equipping Speech-Language Clinicians for the Critical Appraisal of an Artificial Intelligence–Driven, Evidence-Based Future (2025) · cites this paper as Ramanarayanan et al., 2022
New opportunities in interpretability include integrating domain knowledge from clinicians into modelling approaches.
“New opportunities are blossoming in the realm of interpretability, not only encompassing previously discussed areas but also highlighting the potential of integrating domain knowledge from clinicians into modelling approaches [188].”
From Human-centred artificial intelligence for mobile health sensing: challenges and opportunities (2023) · cites this paper as [188]
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References 43 · Cited by 70
- Authors
- Ramanarayanan, V., Lammert, A. C., Rowe, H. P., Quatieri, T. F., & Green, J. R.
- Affiliations
- University of California, San Francisco (US)
- Worcester Polytechnic Institute (US)
- MGH Institute of Health Professions (US)
- Harvard University (US)
- Venue
- Perspectives of the ASHA Special Interest Groups
- Published
- 2022-02-11
- Volume
- 7
- Issue
- 1
- Pages
- 276-283
- ISSN
- 2381-473X (ISSN-L)
- 2381-4764
- OpenAlex
- W4205105230
- Cited by
- 70
- References
- 43
- Citations by year
- 2026: 13 · 2025: 24 · 2024: 19 · 2023: 9 · 2022: 5
- FWCI
- 8.87
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Perspectives of the ASHA Special Interest Groups (publishedVersion)
- Topics
- Health Sciences › Medicine › Physiology › Voice and Speech Disorders
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Emotion and Mood Recognition
- Health Sciences › Health Professions › Health Information Management › Artificial Intelligence in Healthcare
- Keywords
- speech biomarkers, digital biomarkers, automated speech analysis, interpretability, clinical adoption, robustness, specificity, speech analytics, psychiatric conditions, Parkinson's disease, dementia, depression
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