Introduction Heart Failure (HF) is a major health and economic issue worldwide. HF-related expenses are largely driven by hospital admissions and re-admissions, many of which are potentially preventable. Current self-management programs, however, have failed to reduce hospital admissions. This may be explained by their low predictive power for decompensation and high adherence requirements. Slight alterations in the voice profile may allow to detect decompensation in HF patients at an earlier stage and reduce hospitalizations. This pilot study investigates the potential of voice as a digital biomarker to predict health status deterioration in HF patients. Methods and analysis In a two-month longitudinal observational study, we collect voice samples and HF-related quality-of-life questionnaires from 35 stable HF patients. Patients use our developed study application installed on a tablet at home during the study period. From the collected data, we use signal processing to extract voice characteristics from the audio samples and associate them with the answers to the questionnaire data. The primary outcome will be the correlation between voice characteristics and HF-related quality-of-life health status. Ethics and dissemination The study was reviewed and approved by the Cantonal Ethics Committee Zurich (BASEC ID:2022-00912). Results will be published in medical and technical peer-reviewed journals.

The authors have declared no competing interest.

Grant numbers: 22026 Initials of authors who received the award: Filipe Barata Full name of the funder: Hasler Foundation (Haslerstiftung) URLs to sponsors websites: https://haslerstiftung.ch/en/welcome-to-the-hasler-foundation/ The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

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The details of the IRB/oversight body that provided approval or exemption for the research described are given below:

Kantonale Ethikkommission Zurich (Ethics committee of Zurich) gave ethical approval for this work with BASEC Number 2022-00912.

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Data cannot be shared publicly because of ethical requirements. Data are available from the Kantonale Ethikkommission (Cantonal Ethics Committee Zurich) BASEC ID:2022-00912 (contact via info.kek@kek.zh.ch) for researchers who meet the criteria for access to confidential data.