VOICE AND COUGH AS DIGITAL BIOMARKERS (2025–2026): LINGUISTIC EQUITY, PRIVACY, AND THE PROMISE OF ACOUSTIC DIAGNOSTICS IN GLOBAL HEALTH
DOI:
https://doi.org/10.31435/ijitss.3(51).2026.5732Keywords:
Voice Biomarkers, Cough Analysis, Digital Health, Linguistic Equity, Privacy, Global HealthAbstract
Recent advances in artificial intelligence and mobile sensing have renewed interest in the human voice and cough as non-invasive, low-cost biomarkers of disease. While respiratory, neurological, and psychiatric applications have shown moderate-to-high diagnostic accuracies in classification studies, the translation of these tools from proof-of-concept into routine clinical practice remains incomplete. This narrative review synthesizes the 2025–2026 literature across five domains: (a) the biophysiological foundations that make voice and cough acoustically informative, (b) clinical evidence spanning respiratory, neurodegenerative, mental-health, cardiometabolic, pediatric, and laryngeal use cases, (c) the growing body of work on linguistic equity and structural bias in speech-based systems, (d) privacy and adversarial security concerns specific to voice as biometric data, and (e) deployment prospects in low- and middle-income countries, with tuberculosis screening as the most advanced use case. The analysis reveals that no single disease domain has reached the level of large-scale, independently validated deployment, though respiratory and laryngeal applications are closest. Structural language bias—particularly against speakers of tonal languages—remains a first-order obstacle, and current speaker de-identification systems demonstrably leak identity information. These findings point to three conditions for responsible scale-up: methodological standardization, inclusive multilingual datasets, and governance frameworks that treat voice data as sensitive biometric medical information.
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Copyright (c) 2026 Wiktor Adamiec, Damian Danilczuk, Jerzy Buszko, Michał Dyś, Nicol Baran, Marta Bajkowska-Piterak, Przemysław Piterak, Monika Szlachta-Gubernat, Adrianna Buż
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