# Pareto-Optimized AVQI Assessment of Dysphonia: A Clinical Trial Using Various Smartphones
## 4 Results
### AVQI Evaluation Outcomes
A good level of accuracy was achieved, which means that AVQI was able to correctly classify individuals into normal and pathological categories with a high degree of accuracy (the suggested threshold for high precision was an AUC of 0.7, which means that if the AUC value of AVQI was equal to or greater than 0.7, it could be considered a highly accurate diagnostic test to distinguish between normal and pathological voices). Through the use of ROC analysis (see Table 4), we determined that there are optimal AVQI cut-off values that can effectively distinguish between normal and pathological voices for each smartphone used in the study. Furthermore, all of these devices met the proposed 0.7 AUC threshold and demonstrated an acceptable Youden index value. These results indicate that AVQI is a reliable tool for distinguishing between normal and pathological voice, be it using a smartphone or professional recording equipment. Figure 13: ROC curves illustrating the diagnostic accuracy of studio and different smartphone microphones in discriminating normal/pathological voice. Third, a pairwise comparison of the significance of the differences between the AUCs revealed in the present study is presented in Table 5. We used [PERSON]'s test [67] for two correlated ROC curves, which allows us to statistically compare the AUCs of two dependent ROC curves. This test takes into account the correlation between the ROC curves and provides a more accurate comparison of the AUCs. [PERSON]'s test confirmed that there were no statistically significant differences between the AUCs obtained from AVQI measurements obtained from the studio microphone and different smartphones. This means that the ability of AVQI to distinguish between normal and pathological voices was comparable between the studio microphone and different smartphones. The largest difference observed between the AUCs obtained from the studio microphone and different smartphones was only 0.025. This means that the difference in the ability of AVQI to distinguish between normal and pathological voices between the studio microphone and different smartphones was very small. To summarize, across the statistical analysis of the study results, the data demonstrated almost identical and compatible results of AVQI performance between studio microphones and different smartphones. However, it is important to note that differences in the phone operating conditions, microphones within each smartphone series, and version of the operating system software may cause variations in acoustic voice quality measurements between recording systems. Therefore, it is advisable to use the \"VoiceScreen\" app with caution if tests are being performed using multiple devices. For reliable voice screening purposes, it is recommended to perform AVQI measurements using the same device, preferably with repeated measurements. These considerations should also be taken into account when comparing data from acoustic voice analysis between different recording systems, such as different smartphones or other mobile communication devices, and when using them for diagnostic purposes or monitoring voice treatment results.