The science behind the Cardiorespiratory Test

Cardiorespiratory Test:
what is it

The Cardiorespiratory Test exploits the main and peripheral blood circulation activity around all those components that are involved in phonation.
Indeed lungs, diaphragm, vocal folds, the tongue and other elements perceive each heart beat thanks to the blood flow irrorating them, and this means that part of the cardiac information is transduced into the acoustic production.

Validation with the 3-min step test

The score has been built with the 3 minute step test (3MST) as a benchmark, thus comprising several anthropomorphic and cardiac data after a moderate physical effort. For the first time, a new set of acoustic biomarkers has been used thanks to our foundation model which was trained on our complete dataset of respiratory sounds in order to extract respiratory-relevant features from audio recordings.

The score

The score can be a number between 0 and 100, where lower values are index of lower fitness levels and vice versa. From a dataset of 300 audio recordings (58% Male and 42% Female, 37±7.4 years old) labelled with relative fitness level as measured by the 3MST (56% of unfit and 46% of fit), 8560 sound samples were obtained using proprietary augmentation methods. Our first version of the score was able to classify unfit and fit individuals with 80% of accuracy.


Accordion Content

Yes, the VoiceMed’s Cardiorespiratory Score has been rigorously trained and validated using the YMCA 3-minute step test, a gold standard in the field to measure cardiorespiratory fitness (reference: YMCA Fitness Testing and Assessment Manual, YMCA of the USA, Edition 4, 2000).
For the validation, participants performed the step test for 3 minutes, and a doctor measured their heart rate after 60 seconds of rest. Our score was compared to the results of this traditional test (here the table of benchmark). The comparison showed an 80% correlation. The benefit of the Cardiorespiratory Score of VoiceMed is that users don’t need to do any physical activity to receive the results, only breathing towards the smartphone and pronouncing “ahhh”, therefore is more practical, accessible and cost-effective.
By making cardiorespiratory fitness analysis more accessible, we aim to democratize health monitoring, similar to how wearable devices and video analysis have made heart rate measurement more accessible. For detailed validation information, please refer to the VoiceMed Whitepaper.

No, the Cardiorespiratory Score is not classified as medical device software. The app provides individual health-related information for wellness and lifestyle guidance, but it does not offer medical-related data, health measurements, diagnoses, or treatment advice. Therefore, it does not meet the criteria for a medical device and is not subject to regulatory clearance.

No, the Cardiorespiratory Score can be accessed directly from a smartphone through our Software Development Kit (SDK), which can be integrated into your app, or via our standalone app. This eliminates the need for additional wearables and expands your offerings.

The score indicates the user’s cardiorespiratory fitness level, similar to the YMCA 3-minute step test and heart rate variability measurements. It means how well your heart and lungs work together when doing physical activity. Cardiorespiratory fitness matters as it helps go behind the metrics like heart rate or variability, and tries to understand if the user needs physical activity more urgently. The key benefits of analyzing cardiorespiratory fitness include:
1. Encouraging physical activity and promoting healthier lifestyles among members.
2. Establishing a comprehensive health profile for individuals, and identifying areas for improvement, particularly when cardiorespiratory fitness is suboptimal.
3. Good cardiorespiratory fitness reduces cardiovascular risk, mitigates the risk of diseases such as colon cancer and diabetes, and fosters positive mental health by alleviating symptoms of depression, anxiety, and stress.

The test is easy to perform. Users need to use the phone, take 3 deep breaths and pronounce a sustained “aaah.” They then receive a score from 0-100 and suggested actions such as fitness programs or health visits, based on the score. Contact us to request the DEMO.

The next step is suggesting fitness programs to users to improve their Cardiorespiratory Score. The goal is to have a good or excellent fitness level, thus scoring more than 66/100.

One client is suggesting the High Intensive Training for 8 weeks, aimed at improving their cardiorespiratory fitness level. Our Cardiorespiratory Score is always performed at the beginning on all populations, and then once a week for the 8-week fitness programs on the participants that scored under 66/100. The results were an improvement of cardiorespiratory health of 25%, on more than 50% of the program participants.

For a screening use case, measuring it once a month is sufficient. If users are trying to improve their Cardiorespiratory Score with fitness programs like the High Intensive Training program, then once a week is good to motivate users and track each progress.

Integrating voice-based cardiorespiratory fitness measurement with video analysis of vital signs can provide your company with several advantages:

  1. Behavioral insights: the integration of both technologies can provide valuable insights into members’ behaviours and lifestyle choices that impact their cardiovascular health. For example, if a member’s cardiorespiratory fitness is found to be low based on voice analysis, but their vital signs appear normal, it may indicate a need for targeted interventions to improve their fitness levels through exercise and lifestyle changes. These insights can inform personalized health recommendations and incentive programs aimed at improving overall health outcomes and reducing long-term healthcare costs.
  2. Comprehensive health monitoring: by incorporating both video analysis for vital signs and voice analysis for cardiorespiratory fitness, insurance companies can offer a more comprehensive health monitoring solution to their members. This allows for a more holistic understanding of an individual’s health, beyond just heart rate, potentially leading to earlier detection of health issues or risk factors.
  3. Improving risk prediction: cardiovascular health is influenced by multiple factors, including both vital signs and cardiorespiratory fitness. By analyzing both, insurance companies can better predict an individual’s cardiovascular risk profile. This enables them to offer more tailored interventions and proactive measures to help members mitigate their risks, ultimately leading to potential cost savings in terms of reduced claims for cardiovascular-related illnesses or procedures.

Yes, we have users. Our ideal targets include:

  • Sedentary workers: Office workers, IT professionals, remote workers.
  • Older adults: Those aged 65 and older.
  • People with chronic conditions: Hypertension, diabetes, obesity, metabolic syndrome.
  • Students: Especially those in higher education.
  • Postpartum women: New mothers.
  • Smokers and ex-smokers.
  • People with a family history of cardiovascular disease.
  • Health insurance, promoting better lifestyle with prevention. The ones who want to reduce costs and act on prevention.
  • Healthcare providers that are offering also wellbeing programs to improve health that include fitness and nutrition.
  • Health and wellbeing apps.

Currently, our cardiorespiratory test has not been compared with VO2max, but such a comparison can be conducted in a future study.

VoiceMed technology can be used: by integrating the SDK, which is the easiest and fastest for your company, or the API in case you want to combine our score with other scores, or we have the end-to-end application.

Yes, we can integrate the test into your app with the SDK/APIs. Contact us to have more info.

Yes. Contact us to try the DEMO and test the entire flow.

We have an initial set-up fee, and then a price per test depending on the amount.

More information

Contact for a detailed white paper on Voicemed’s technology.