arXiv · 2505.06412
Cross-Domain Transfer of Depression Voice Biomarkers Depends on the Outcome Instrument: Leakage-Controlled Cross-Sectional Evaluation Study
Abstract
Whether voice biomarkers of depression generalize across clinical settings is largely untested. Generalization is usually framed as a question about populations. It is also a question about the outcome instrument a model is scored against -- a dimension largely unexamined. In a US-nationwide online study, 446 sessions from 390 pregnant participants at 22 weeks' gestation (analytical N=316) gave four voice recordings each, the PHQ-8 and a modified 9-item EPDS. Discrimination was assessed under leakage-controlled cross-validation with inside-fold selection, participant-grouped folds, a negative-control harness and multiplicity adjustment across a pre-specified 4 task x 4 outcome grid. The prenatal-trained model was applied to two general-psychiatric corpora (DAIC-WOZ, N=189; E-DAIC, N=219) under pure held-out inference; an open-source model trained on ~35,000 individuals was applied without refitting to all three. The pre-registered within-cohort outcome performed at chance (AUC 0.494, 95% CI 0.431-0.560), and no grid cell survived multiplicity adjustment under either of two modeling paradigms. The prenatal-trained model did not transfer (AUC 0.505, 0.478). Transfer in the reverse direction depended on the instrument, not the population: the general-population model reached 0.706-0.708 on general-psychiatric speech, 0.510 against the PHQ-8 in pregnant women, and 0.645 against the modified EPDS in the same women. The mechanism is visible at item level: the model tracks affective distress and is flat on somatic items, while the PHQ-8 in pregnancy is dominated by somatic content that gestation elevates. Validation should specify population, elicitation task and outcome instrument; a tool validated against one instrument should not be assumed to work against another. This version supersedes v1: a label scoring defect found in peer review is corrected and all analyses redone.
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Rachel L. Wiley, Jim Schwoebel, Joel Shor, Matias Caccia, Adolfo M. García, Sheehan D. Fisher, Martin G. Frasch. 2025-05-09. Cross-Domain Transfer of Depression Voice Biomarkers Depends on the Outcome Instrument: Leakage-Controlled Cross-Sectional Evaluation Study. https://arxiv.org/abs/2505.06412
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