Automated diagnostic hearing test

• US 20040006283A1
• Filed: 05/15/2003
• Published: 01/08/2004
• Est. Priority Date: 05/23/2002
• Status: Active Grant

• Current Assignee: Biocell LP, Tympany Inc. (Tympany Holdings LLC)
• Original Assignee: Tympany Inc. (Tympany Holdings LLC)
• Inventors: Wasden, Christopher L., Thornton, Aaron, Stott, Kenneth R., Strasnick, Barry, Harrison, Jeffrey S.
• Granted Patent: US 7,695,441 B2
• Time in Patent Office: Days
• US Class Current: 600/559
• CPC Class Codes: A61B 5/0051 by applying vibrations
• CPC Class Codes: A61B 5/12 Audiometering
• CPC Class Codes: A61B 5/121 evaluating hearing capacity
• CPC Class Codes: A61B 5/742 using visual displays A61B5/339 takes precedence
• CPC Class Codes: H04R 2460/13 Hearing devices using bone conduction transducers
• CPC Class Codes: H04R 25/606 acting directly on the eardrum, the ossicles or the skull, e.g. mastoid, tooth, maxillary or mandibular bone, or mechanically stimulating the cochlea, e.g. at the oval window
• CPC Class Codes: H04R 25/70 Adaptation of deaf aid to hearing loss, e.g. initial electronic fitting

Abstract

Method and system are disclosed for automated testing of a patient'"'"'s hearing. The automated hearing test allows the patient to quickly and accurately test his own hearing with minimal or no assistance from an audiologist or other hearing health professionals. The test prompts and instructs the patient for inputs and responses as needed as needed. The patient can select one or several tests to be performed, including air and bone conduction testing with masking, speech reception threshold, speech discrimination, and tympanogram/acoustic reflex testing. Multiple languages are supported. Data obtained from one test may be used for another test or another iteration of the same test to calculate masking levels. The automatic hearing test also detects ambient noise and can compensate for it in the test results. If a contingency occurs, the automated hearing test is configured to page the operator for assistance.

Claims

1. A computer-based, multimedia method for allowing a patient to quickly and conveniently test his own hearing without a sound isolation chamber and with minimal assistance from an operator, comprising:

presenting to the patient a list of available hearing tests, including a pure tone test, a speech reception test, and a speech discrimination test;

prompting the patient to select one or more hearing tests from the list of available hearing tests;

performing each hearing test selected by the patient, wherein data obtained during one hearing test may be used in another hearing test, and data obtained during one iteration of a hearing test may be used in subsequent iterations of that hearing test; and

paging the operator upon completion of the selected hearing tests.

2. The method according to claim 1, further comprising prompting the patient to select from a list of available languages to be used for the hearing tests.

3. The method according to claim 1, wherein the list of available hearing tests includes a tympanogram/acoustic reflex test, further comprising acquiring tympanogram/acoustic reflex data for each ear of the patient if the tympanogram/acoustic reflex test is selected.

4. The method according to claim 1, wherein the pure tone test comprises obtaining a hearing threshold for a plurality of predetermined frequencies between 250 Hz and 8000 Hz.

5. The method according to claim 4, wherein the pure tone test further comprises skipping the hearing threshold for certain frequencies if the hearing threshold for other frequencies meet predefined criteria.

6. The method according to claim 4, wherein the step of obtaining a hearing threshold comprises, for each frequency being tested, obtaining an unmasked bone conduction hearing threshold for the patient and determining a better ear and a poorer ear based on the unmasked bone conduction threshold.

7. The method according to claim 6, wherein the step of obtaining a hearing threshold further comprises, for each frequency being tested, determining one or more hearing thresholds, including at least an air conduction hearing threshold for the better ear and the poorer ear.

8. The method according to claim 7, wherein the step of obtaining a hearing threshold further comprises, for the first frequency being tested, issuing a bone conduction threshold warning if the air conduction hearing threshold for the better ear is larger than the unmasked bone conduction threshold by a predetermined amount.

9. The method according to claim 7, wherein the step of obtaining a hearing threshold further comprises, for each frequency being tested, determining a masked bone hearing threshold for the poorer ear if an air-bone gap for either ear is larger than a predetermined amount.

10. The method according to claim 9, wherein the step of obtaining a hearing threshold further comprises, for each frequency being tested, determining a masked bone hearing threshold for the better ear if a masked bone-unmasked bone gap for the poor ear is smaller than a predetermined amount.

11. The method according to claim 10, wherein the step of obtaining a hearing threshold further comprises, for each ear and frequency being tested, evaluating whether masking levels used for all hearing thresholds were correct, and correcting the masking levels as needed based on available hearing thresholds.

12. The method according to claim 7, wherein the step of determining one or more hearing thresholds includes estimating an initial intensity level to be used for each ear and frequency being tested.

13. The method according to claim 12, wherein the step of determining one or more hearing thresholds includes, for each ear and frequency being tested, estimating a masking level to be used and terminating the determination if the estimated masking level results in a masking dilemma.

14. The method according to claim 13, wherein the step of determining one or more hearing thresholds includes, for each ear and frequency being tested, introducing a random delay before presenting a tone to the patient if the estimated masking results in a masking level change.

15. The method according to claim 13, wherein the step of determining one or more hearing thresholds includes, for each ear and frequency being tested, introducing a random delay before presenting a tone to the patient if the patient made any previous responses.

16. The method according to claim 13, wherein the step of determining one or more hearing thresholds includes, for each ear and frequency being tested, presenting a tone with a frequency substantially equal to the frequency being tested and waiting for the patient to respond.

17. The method according to claim 16, wherein the step of determining one or more hearing thresholds includes, for each ear and frequency being tested, issuing a false response warning to the patient if the response is received before the tone presentation and masking is being used for the first time.

18. The method according to claim 16, wherein the step of determining one or more hearing thresholds includes, for each ear and frequency being tested, checking whether a hearing threshold is reached upon receiving the response within an acceptable time.

19. The method according to claim 16, wherein the step of determining one or more hearing thresholds includes measuring an ambient noise and determining an ambient noise indicator.

20. The method according to claim 19, wherein the ambient noise indicator is an ambient noise threshold shift, and the ambient noise threshold shift must be greater than the current intensity of the tone for a predetermined number of iterations before intensity of the tone is increased.

21. The method according to claim 12, wherein the step of estimating an initial intensity level includes presenting a tone to the patient at a predetermined starting intensity and increasing the intensity of the tone by a predetermined increment until the patient responds.

22. The method according to claim 18, wherein the step of checking whether a hearing threshold has been reached includes, for the intensity being used, marking the hearing threshold as an overlimit threshold if the patient fails to respond to an intensity near an equipment upper intensity limit.

23. The method according to claim 22, wherein the step of checking whether a hearing threshold has been reached further includes, for the intensity being used, calculating a plurality of threshold indicators, including:

a total number of responses at intensities within a predetermined amount of the intensity being used;

a number of responses at the intensity being used;

a number of non-responses at the intensity being used;

a number of non-responses at a lower intensity level that were unaffected by ambient noise;

a number of reversals in intensity presentation; and

an average of intensity levels where reversals occurred.

24. The method according to claim 23, wherein a hearing threshold has been reached if the number of responses at the intensity being used is greater than the number of non-responses at the intensity being used, provided the number of responses at the intensity being used is greater than a predetermined minimum response and the intensity being used is greater than a previous intensity used.

25. The method according to claim 24, wherein the step of checking whether a hearing threshold has been reached further includes increasing the predetermined minimum response to allow for training.

26. A system for allowing a patient to quickly and conveniently test his own hearing without a sound isolation chamber and with minimal assistance from an operator, comprising:

transducers, including an air conduction transducer and a bone conduction transducer, mounted on a single headset;

a hearing test device connected to the transducers;

a computer connected to the hearing test device and storing an automated hearing test thereon, the automated hearing test configured to cause the computer to;

present to the patient a list of available hearing tests, including a pure tone test, a speech reception test, and a speech discrimination test;

prompt the patient to select one or more hearing tests from the list of available hearing tests;

perform each hearing test selected by the patient, wherein data obtained during one hearing test may be used in another hearing test, and data obtained during one iteration of a hearing test may be used in subsequent iterations of that hearing test; and

page the operator upon completion of the selected hearing tests.

27. The system according to claim 26, wherein the main program module further causes the computer to prompt the patient to select from a list of available languages to be used for the hearing tests.

28. The system according to claim 26, wherein the computer is further connected to a tympanometer, and the list of available hearing tests includes a tympanogram/acoustic reflex test, the automated hearing test further causes computer to acquire tympanogram/acoustic reflex data for each ear of the patient if the tympanogram/acoustic reflex test is selected.

29. The system according to claim 26, wherein the automated hearing test includes a pure tone module configured to cause the computer to obtain a hearing threshold for a plurality of predetermined frequencies between 250 Hz and 8000 Hz.

30. The system according to claim 29, wherein the pure tone module further causes the computer to skip the hearing threshold for certain frequencies if the hearing threshold for other frequencies meet predefined criteria.

31. The system according to claim 29, wherein the automated hearing test further includes a pure tone threshold module configured to cause the computer to obtain, for each frequency being tested, an unmasked bone conduction hearing threshold for the patient and determine a better ear and a poorer ear based on the unmasked bone conduction threshold.

32. The system according to claim 31, wherein the pure tone threshold module further causes the computer to determine, for each frequency being tested, one or more hearing thresholds, including at least an air conduction hearing threshold for the better ear and the poorer ear.

33. The system according to claim 32, wherein the pure tone threshold module further causes the computer to issue, for the first frequency being tested, a bone conduction threshold warning if the air conduction hearing threshold for the better ear is larger than the unmasked bone conduction threshold by a predetermined amount.

34. The system according to claim 32, wherein the pure tone threshold module further causes the computer to determine, for each frequency being tested, a masked bone hearing threshold for the poorer ear if an air-bone gap for either ear is larger than a predetermined amount.

35. The system according to claim 34, wherein the pure tone threshold module further causes the computer to determine, for each frequency being tested, a masked bone hearing threshold for the better ear if a masked bone-unmasked bone gap for the poor ear is smaller than a predetermined amount.

36. The system according to claim 35, wherein the pure tone threshold module further causes the computer to evaluate, for each ear and frequency being tested, whether masking levels used for all hearing thresholds were correct, and to correct the masking levels as needed based on available hearing thresholds.

37. The system according to claim 32, wherein automated hearing test further includes a pure tone intensity module configured to cause the computer to determine the one or more hearing threshold by estimating an initial intensity level to be used for each ear and frequency being tested.

38. The system according to claim 37, wherein the pure tone intensity module further causes the computer to estimate, for each ear and frequency being tested, a masking level to be used and to terminate the estimation if the estimated masking level results in a masking dilemma.

39. The system according to claim 38, wherein the pure tone intensity module further causes the computer to introduce, for each ear and frequency being tested, a random delay before presenting a tone to the patient if the estimated masking results in a masking level change.

40. The system according to claim 38, wherein the pure tone intensity module further causes the computer to introduce, for each ear and frequency being tested, a random delay before presenting a tone to the patient if the patient made any previous responses.

41. The system according to claim 38, wherein the pure tone intensity module further causes the computer to present, for each ear and frequency being tested, a tone with a frequency substantially equal to the frequency being tested through the audiometer and waiting for the patient to respond.

42. The system according to claim 41, wherein the pure tone intensity module further causes the computer to, for each ear and frequency being tested, issue a false response warning to the patient if the response is received before the tone presentation and masking is being used for the first time.

43. The system according to claim 41, wherein the pure tone intensity module further causes the computer to, for each ear and frequency being tested, check whether a hearing threshold is reached upon receiving the response within an acceptable time.

44. The system according to claim 41, wherein the pure tone intensity module further causes the computer to measure and ambient noise and calculate an ambient noise indicator.

45. The system according to claim 44, wherein the ambient noise indicator is an ambient noise threshold shift, and the ambient noise threshold shift must be greater than the current intensity of the tone for a predetermined number of iterations before intensity of the tone is increased.

46. The system according to claim 37, wherein the automated hearing test further includes a pure tone initial intensity determination module configured to cause the computer to estimate the initial intensity level by presenting a tone to the patient at a predetermined starting intensity and increasing the intensity of the tone by a predetermined increment until the patient responds.

47. The system according to claim 43, wherein the automated hearing test further includes a threshold detection module configured to cause the computer to check whether a hearing threshold has been reached for the intensity being used by marking the hearing threshold as an overlimit threshold if the patient fails to respond to an intensity near an equipment upper intensity limit.

48. The system according to claim 47, wherein the threshold detection module further causes the computer to calculate, for the intensity being used, a plurality of threshold indicators, including:

a total number of responses at intensities within a predetermined amount of the intensity being used;

a number of responses at the intensity being used;

a number of non-responses at the intensity being used;

a number of non-responses at a lower intensity level that were unaffected by ambient noise;

a number of reversals in intensity presentation; and

an average of intensity levels where reversals occurred.

49. The system according to claim 48, wherein a hearing threshold has been reached if the number of responses at the intensity being used is greater than the number of non-responses at the intensity being used, provided the number of responses at the intensity being used is greater than a predetermined minimum response and the intensity being used is greater than a previous intensity used.

50. The system according to claim 49, wherein the threshold detection module further causes the computer to increase the predetermined minimum response to allow for training.