Methods of assessing the pathological and/or physiological state of a subject, methods of monitoring a subject with heart failure or a subject that has been diagnosed as having or being at risk of having a condition associated with dyspnea and/or fatigue, and methods of diagnosing a subject as having decompensated heart failure are provided. The methods comprise obtaining a voice recording from a word-reading test from the subject, wherein the voice recording is from a word-reading test comprising reading a sequence of words drawn from a set of n words and analysing the voice recording, or a portion thereof. The analysing can comprise identifying a plurality of segments of the voice recording that correspond to single words or syllables; determining the value of one or more metrics selected from the breathing %, unvoicing/voicing ratio, voice pitch and correct word rate at least in part based on the identified segments; and comparing the value of the one or more metrics with one or more respective reference values. Related systems and products are also described.