Say 'Ahh': New App Uses Voices As Biomarker To Screen For Illness

Download Audio
The Sonde One health app will analyze smartphone audio recordings and screen them for potential voice illnesses. (Kiichiro Sato/AP)
The Sonde One health app will analyze smartphone audio recordings and screen them for potential voice illnesses. (Kiichiro Sato/AP)

Picture this: You wake up one morning with a cough and a sore throat. You think you might be getting sick, but you don't know if you should see a doctor.

Worse yet, you don't know if you really should see the doc because you're worried about COVID-19.

But now there's an app for that — and all it wants is your voice.

"Whether it be respiratory illness or asthma or COVID-19, give us six seconds of voice, and we'll give you a clear indication of what your health symptoms are," says David Liu, CEO of the Boston-based digital medicine company Sonde Health.

After thousands of voice tests, the Sonde Health smartphone app is out with a pilot program that will screen people's voices for illnesses.

Sonde's co-founder Jim Harper says our voices can be a biomarker of health issues, much like taking your temperature or blood pressure.

"You can think of it a lot like a conversation that you may have had many times in the past with your mother," explains Harper, "where in the first few seconds she can pick up on changes in your voice that reflect things like whether you have a cold, whether you've been tired."

Sonde stresses the app is not an approved medical product and can't diagnose illnesses like COVID-19 by itself. But they say the app's algorithm detects symptoms of respiratory conditions like asthma or pulmonary disease in around 70 percent of patients.

Company CEO David Liu says 10 companies in the U.S. and India are using its technology to help employees screen for COVID-19 and says its voice screening tests could help contain the surging pandemic if lots of people use it every day.

"If you want to control the spread, you need a screening or filtering regimen in a large population," Liu says. "This is the formula for how you do it: begin to use tools like this."

So I tried the app's respiratory screening test myself.

Instructions for the Sonde One app. (Courtesy Jim Harper/Sonde Health)
Instructions for the Sonde One app's respiratory screening test. (Courtesy Jim Harper/Sonde Health)

The first thing I see is a section called "Respiratory Symptom Risk." The screen tells me I have a questionnaire and a voice activity to complete.

There are seven questions, such as, "Have I been within six feet of someone with a confirmed covid case?" and "Do I have a fever or a cough?"

I'm feeling pretty good, so I select "No."

Then I'm asked to inhale and hold a vowel sound for at least six seconds — the familiar vowel sound you often make at the doctor's office: "ahhh."

Harper says the app compares my voice sample to thousands of others in the company's database and calculates a risk score for respiratory illnesses.

"There is a small handful, really two or three, changes that cause things like shortness of breath or coughing or difficulty breathing," says Harper. "What that score is reflecting is how similar those handful of voice characteristics are in your voice to people that have known changes in those respiratory symptoms."

Within seconds, the app tells me I'm at low risk. I'm not surprised, but I am relieved. Then, I rerun the test to confirm my results, and it comes out the same.

The Sonde app may be new, but the theory behind it is not.

Voice pathologist Doug Roth of Brigham and Women's Hospital has been a human voice screener for the last 20 years.

"I'm listening to the quality of somebody's voice," Roth says. "And for example, if somebody breathy, you can hear some breathiness in the voice. There's a roughness, you can hear roughness in the voice. So there are different aspects of the voice that we listen for and they give us some indication of what might be going on."

Roth says voice pathologists rely mostly on their ears to identify vocal problems, but  clinics are using voice measurement technology more frequently to help identify diseases. Roth tried the Sonde app and says it could be useful for providing a general idea of someone's vocal health. But he warns that technology only tells part of the story.

"What we measure doesn't always perfectly line up with what our ear tells us that we're hearing, which is why we don't just use measurements," Roth explains. "Those things can still be hard to measure because it can deviate in so many different ways."

An app screening can't take the place of a diagnosis by a clinician. But Sonde CEO Liu believes it can help people stay on top of their health if they use it frequently.

"That actionable insights is what we hope will drive healthy behaviors and even take a step toward preventative or preventive health care."

Who knew you might learn so much about your health from an app by just saying "ahhh" — and without that wooden popsicle stick taste, too?

This segment aired on December 15, 2020.

Headshot of Bob Oakes

Bob Oakes Senior Correspondent
Bob Oakes was a senior correspondent in the WBUR newsroom, a role he took on in 2021 after nearly three decades hosting WBUR's Morning Edition.


Headshot of Khari Thompson

Khari Thompson Producer, Radio Boston
Khari Thompson is a producer for Radio Boston.



More from WBUR

Listen Live