Towards Robust Assessment of Pathological Voices via Combined Low-Level Descriptors and Foundation Model Representations

Perceptual voice quality assessment is essential for diagnosing and monitoring voice disorders by providing standardized evaluations of vocal function. Traditionally, expert raters use standard scales such as the Consensus Auditory-Perceptual Evaluation of Voice (CAPE-V) and Grade, Roughness, Breathiness, Asthenia, and Strain (GRBAS). However, these metrics are subjective and prone to inter-rater variability, motivating the need for automated, objective assessment methods. This study proposes Voice Quality Assessment Network (VOQANet), a deep learning-based framework with an attention mechanism that leverages a Speech Foundation Model (SFM) to extract high-level acoustic and prosodic information from raw speech. To enhance robustness and interpretability, we also introduce VOQANet+, which integrates low-level speech descriptors such as jitter, shimmer, and harmonics-to-noise ratio (HNR) with SFM embeddings into a hybrid representation. Unlike prior studies focused only on vowel-based phonation (PVQD-A subset) of the Perceptual Voice Quality Dataset (PVQD), we evaluate our models on both vowel-based and sentence-level speech (PVQD-S subset) to improve generalizability. Results show that sentence-based input outperforms vowel-based input, especially at the patient level, underscoring the value of longer utterances for capturing perceptual voice attributes. VOQANet consistently surpasses baseline methods in root mean squared error (RMSE) and Pearson correlation coefficient (PCC) across CAPE-V and GRBAS dimensions, with VOQANet+ achieving even better performance. Additional experiments under noisy conditions show that VOQANet+ maintains high prediction accuracy and robustness, supporting its potential for real-world and telehealth deployment.