“…Although numerous studies have shown the strong relationship between dysphonia and CPP 3,[7][8][9][10][11][12][13][14][15][16] , significant external factors unrelated to dysphonia may also influence CPP. These factors include patient-controlled factors (such as prosodic changes in loudness or fundamental frequency [17][18][19][20][21][22][23][24] ), recording environment or microphone used 25,26 , stimuli type (sustained vowel, continuous speech), and phonemes present in stimuli 17,[27][28][29][30][31][32][33] , as well as the program used to calculate CPP values 9,10,15,24,26,27,[34][35][36] . Therefore, it is essential that clinicians using CPP reduce as many of these external factors as possible when comparing across patients or within the same patient across time points (i.e., before and after therapy).…”