ISO_639-1 en false 2012-10-10 Kerrie Lee Hearing Health Program, Northern Territory kerrie.lee2@bigpond.com Amarjit Anand, NT Department of Health/NT Hearing Judith Boswell, Adelaide Hearing Consultants, Australia Stephen Chu, NEHTA, Australia Kimberley Crebbin, NT Hearing Services, Australia Kathy Currie, Northern Territory Health, Australia Lisa Dawson, NT Hearing, Northern Territory Jade Frederiksen, Hearing Health Program, DoH, Australia Sam Harkus, Australian Hearing, Australia Sam Heard, Ocean Informatics, Australia (Editor) Paul Hickey, Hearing Health Program, Australia Oliver Hosking, Remote Health NT, Australia Anthony Leech, Hearing Health, Australia Kerrie Lee, Ngaanyatjarra Health Service, Australia Heather Leslie, Ocean Informatics, Australia (Editor) Rebecca Matthews, NT Hearing Services - NTG, Australia Ian McNicoll, Ocean Informatics UK, United Kingdom Mark Ramjan, NT Department of Health, Australia Bojana Sarkic, Northern Territory Government, Australia Kelly Simmons, Department of Health, Australia Prasha Sooful, Royal Darwin Hospital, Australia Fiona Wake, RAHC, Australia in_development This work is licensed under the Creative Commons Attribution-ShareAlike 4.0 International License. To view a copy of this license, visit http://creativecommons.org/licenses/by-sa/4.0/. Nasjonal IKT Sabini P, Sclafani AP. Efficacy of serologic testing in asymmetric sensorineural hearing loss. Otolaryngol Head Neck Surg. 2000 Apr;122(4):469-76. PubMed PMID: 10740163. Heather Leslie, Ocean Informatics, heather.leslie@oceaninformatics.com no.nasjonalikt Nasjonal IKT no.nasjonalikt 461410114E2BDA8F0C0753D0C936F4C1 f559cd15-280e-49e5-b09d-392bea982551 0.0.1-alpha

ISO_639-1 en To record measurements of hearing acuity using a calibrated hearing test device, and their interpretation by a clinician. hearing test audiogram audiometry acuity threshold decibels ABR VROA VRA play Use to record measurements and related findings for a single identified test of hearing acuity, for each ear tested separately or both ears simultaneously, via air conduction and/or bone conduction, with masking when required. Use to record the interpretation of all measurements of hearing acuity for each ear or both ears if tested simultaneously, and an overall interpretation (or audiological diagnosis). This archetype has been designed to capture hearing threshold determination for air conduction and/or bone conduction (with or without masking) for the following tests: - Pure Tone Audiometry; - Play Audiometry; - Auditory Brainstem Response; and - Visual Reinforcement Orientation Audiometry. All of the data elements are recorded using a single method or protocol. If, during the test, any of the protocol parameters need to be modified, then the subsequent part of the test will need to be recorded within a separate instance of the test data, using the updated protocol parameters. Not to be used for hearing screening assessment - use the OBSERVATION.hearing_screening archetype. Not to be used to record other auditory assessments such as: - Behavioural Observation Audiometry (BOA); - Most Comfortable Listening Level (MCL) and Uncomfortable Listening Level (UCL); and - Auditory Brainstem Response (ABR) for any purpose other than hearing threshold determination. These assessments need to be recorded in specific archetypes for the purpose. © Nasjonal IKT HF

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true 1 CLUSTER true false true 0 at0047 archetype_id/value matches {/openEHR-EHR-CLUSTER\.device-hearing_test_instrument(-[a-zA-Z0-9_]+)*\.v1/} Boolean 2007 false String archetype_id/value attribute C_STRING openEHR-EHR-CLUSTER\.device-hearing_test_instrument(-[a-zA-Z0-9_]+)*\.v1 constraint CLUSTER true false true 0 at0149 archetype_id/value matches {/openEHR-EHR-CLUSTER\.device(-[a-zA-Z0-9_]+)*\.v1/} Boolean 2007 false String archetype_id/value attribute C_STRING openEHR-EHR-CLUSTER\.device(-[a-zA-Z0-9_]+)*\.v1 constraint ELEMENT true false true 0 at0134 value true true false false 0 1 DV_TEXT true true false false 1 1 ELEMENT true true false false 0 1 at0119 value true true false false 0 1 DV_TEXT true true false false 1 1 ELEMENT true true false false 0 1 at0089 value true true false false 0 1 DV_CODED_TEXT true true false false 1 1 defining_code true true false false 1 1 CODE_PHRASE true true false false 1 1 local at0090 at0091 at0092 ELEMENT true true false false 0 1 at0061 value true true false false 0 1 DV_CODED_TEXT true true false false 1 1 defining_code true true false false 1 1 CODE_PHRASE true true false false 1 1 local at0062 at0063 DV_TEXT true true false false 1 1 ELEMENT true true false false 0 1 at0138 value true true false false 0 1 DV_TEXT true true false false 1 1 ELEMENT true true false false 0 1 at0120 value true true false false 0 1 DV_TEXT true true false false 1 1 false false true false true 0 Audiometry Result Record of measurements of hearing acuity using a calibrated hearing test device, and their clinical interpretation. Event Series @ internal @ Any Event Default, unspecified point in time which may be explicitly defined in a template or at run-time. For example, in a template, this event can be cloned and specifically identified to be the first and/or second test conducted as a part of a comprehensive assessment, such as a Hearing Conservation or Industrial Audiometric Assessment. Tree @ internal @ Result Details The test result measurements and interpretations which can be recorded per ear, or for both ears simultaneously. Test Ear Identification of the ear(s) to which the test stimulus is being presented. Left Ear The test stimuli were presented to the left ear only. Right Ear The test stimuli were presented to the right ear only. Frequency The stimulus frequency tested. Frequency is not applicable if a click stimulus is presented. Threshold Level The stimulus intensity at threshold for the test frequency. Tree @ internal @ Test Result Image Digital representation of the entire result. Comment Additional narrative about the test results and intepretation not captured in other fields. Aided Status Indication regarding use of an assistive listening device by the test subject during the test. Left Aided Left ear testing has been aided by a hearing device, such as a hearing aid or cochlear implant. Unaided Testing has not been aided by a hearing device, such as a hearing aid or cochlear implant. Tree @ internal @ Test Stimulus Identification of the stimulus used in the hearing test to measure the hearing threshold. Tone Burst The test stimulus is a tone burst. Click The test stimulus is a click. Test Result Name Identification of the Audiometry test performed. Coding with an external terminology is preferred, where possible. Applicable tests include: Pure Tone Audiometry; Play Audiometry; Auditory Brainstem Response (for threshold determination); and Visual Reinforcement Orientation Audiometry. Test Instrument Details of device used to conduct the test. Details of the headphones and bone conductors that are calibrated to be used in conjunction with a specific hearing test instrument will be nested as specific CLUSTER archetypes within the CLUSTER.hearing_test_instrument archetype. Measurement The measured frequency/threshold dB level pair for air conduction results. Binaural The test stimuli were presented to both ears simultaneously in a soundfield. Hearing Threshold Interpretation Interpretation of a series of audiometric measurements for purposes of hearing threshold assessment. Pure Tone Average The average pure tone threshold according to the specified averaging criteria. This calculation is typically determined using air conduction thresholds. Criteria for Pure Tone Average The criteria on which the Pure Tone Average is calculated. The average is based on air conduction thresholds and masked thresholds replace unmasked thresholds when applying the formula. If recording the Criteria as a narrative, it is possible to identify the frequencies used for non-standard Pure Tone Average as free text. 3 frequency average The pure tone hearing threshold is calculated using 0.5, 1 and 2 kHz. 4 frequency average The pure tone hearing threshold is calculated using 0.5, 1, 2 and 4 kHz. Type of Loss Identified type of hearing loss for the test ear, based on all measurements. If there is no degree of loss, then this data element is not applicable. Mixed A mixed hearing loss pattern has been identified for the Test Ear, based on the presence of an air/bone gap and bone conduction thresholds outside normal range. Sensorineural A sensorineural hearing loss pattern has been identified for the Test Ear, based on no air/bone gap and thresholds outside normal range. Conductive A conductive hearing loss pattern has been identified for the Test Ear, based on the presence of an air/bone gap and bone conduction thresholds within normal range. Indeterminate It is not possible to determine the pattern of hearing loss. Clinical Interpretation Clinical interpretation of all measurements for the test ear. Coding with a terminology is preferred, where possible. Not to be used for recording the interpretation for both ears when the ears are tested simultaneously - use the data element 'Overall Interpretation' instead. Sensorineural Symmetry An interpretation about the symmetry of sensorineural component of hearing loss, based on bone conduction measurements for both ears. Symmetrical The hearing loss is symmetrical. Asymmetrical The hearing loss is asymmetrical. Test Environment The environment in which the audiometric test is administered. This data element is commonly used in industry hearing programs. Audiometric booth Sound treated room that provides a test environment that meets audiometric standards for ambient noise inside the booth. Warble Tone The test stimulus is a frequency modulated tone. Pure Tone The test stimulus is a pure tone. Click Stimulus Specification Identification of parameters specifying a click stimulus. Onset Ramp Time over which the stimulus grows to full amplitude. Offset Ramp Time over which the stimulus depletes to zero amplitude. Total Duration Total duration of the click stimulus. Calibration Reference dB Scale used for acoustic calibration of the test signal. dB SPL The test stimuli are calibrated using the sound pressure level scale. dB HL The test stimuli are calibrated using the hearing level scale. dB nHL The test stimuli are calibrated using the normal hearing level scale. Threshold Determination Protocol Protocol used to measure the hearing threshold for pure tone, play and visual reinforcement orientation audiometry only. Not applicable for ABR testing. Step Size The step size (in decibels) of the change in the stimulus intensity for threshold determination. 1 dB Step size of one decibel. 5 dB Step size of five decibels. 10 dB Step size of ten decibels. 20 dB Step size of twenty decibels. Direction The direction of change in the stimulus intensity. Ascending Threshold is calculated based on the ascending runs where the stimulus moves from below threshold to above threshold. Descending Threshold is calculated based on the descending runs where the stimulus moves from above threshold to below threshold. Air Presentation Presentation of the air conduction test stimulus indirectly to the inner ear through the atmosphere, via the auditory canal and middle ear structures. Soundfield The stimulus is presented via a loudspeaker located at least one metre away from the subject. Insert Earphone The stimulus is presented via insert earphones. Headphones The stimulus is presented via external headphones - either circumaural or supraaural.. Bone Presentation Presentation of the bone conduction test stimulus directly to the inner ear via the cranial bones. Mastoid The posterior part of the temporal bone, including the mastoid process. Forehead Area of the head bounded by the normal hairline, eyebrows and the temples on either side. Test Modifications Required Narrative description of any modfications to the standard methodology required to enable successful completion of the test. Comment Additional narrative about the protocol for the audiogram not captured in other fields. For example, the co-operation of the test subject or description of the method used for testing. Overall Interpretation Overall clinical interpretation of the measurements and related findings using an audiometer. Coding with a terminology is preferred, where possible. This data element is effectively an audiological diagnosis. Binaural test results reflects either the performance for both ears (if equal hearing) or only the better ear (where there is asymmetric hearing)." No Test Result No air conduction test result is available for the test ear. Record as True if the clinician was unable to record a result for the test ear or binaural testing in a soundfield, as defined by the 'Test Ear' data element. Reason for No Result Reason why no air conduction result is available for the test ear. For example, patient was not cooperative; patient was not capable; ran out of time. Articulation Index An algorithm to predict the amount of speech that is audible to a patient with a specific hearing loss. Threshold Definition Definition of the protocol used to define the threshold level used in the test. Minimum response level The softest level at which a subject responds to a stimulus. 2/3 responses The softest level at which the subject responds to two out of three consecutive threshold runs. 3/6 responses The softest level at which the subject responds to three out of six consecutive threshold runs. Laterality of Loss An interpretation about the laterality of hearing loss, based on all hearing acuity measurements for both ears. If there is no degree of loss in both ears, then this data element is not applicable. Bilateral Loss of hearing in both ears. Unilateral Loss of hearing in one ear. Reliability Narrative description of the reliability of the test results, as determined by the tester. If an appropriate value set can be determined, this could be coded. The maximum occurrences of this data element have been set to two to allow for both narrative and a coded value to be selected in a template. Degree of Loss Category of the degree of hearing loss derived from the dB threshold values using specified criteria. Coding with a terminology is desirable, where possible. For example: none, mild, moderate, severe and profound. Each of these categories should be clearly defined on the basis of a dB range appropriate for age. Criteria for Asymmetry The criteria on which asymmetry is defined in the test result interpretation. For example: binaural difference in bone conduction thresholds of >10 dB at two consecutive frequencies or >15 dB at one frequency (0.25–8.0 kHz). Air Conduction Result The thresholds obtained using air conduction testing. Bone Conduction Result The thresholds obtained using bone conduction testing. Air Conduction Masking A masking stimulus was applied to the non-test ear to obtain specified air conduction thresholds. Bone Conduction Masking A masking stimulus was applied to the non-test ear to obtain specified bone conduction thresholds. Measurement The measured frequency/threshold dB level pair for bone conduction results. Frequency The stimulus frequency of the test signal. Threshold Level The intensity of the test stimulus at the subject's threshold for the test frequency. No Test Result No bone conduction test result is available for the test ear. Reason for No Result Reason why no bone conduction result is available for the test ear. Narrow Band Noise The test stimulus is a narrow band noise centred on the specified frequency. Hearing Device Details of the hearing device used. For example: hearing aid or bone conductor aid. Right Aided Right ear testing has been aided by a hearing device, such as a hearing aid or cochlear implant. Bilateral Aided Testing has been aided by use of bilateral hearing devices, such as a hearing aids or cochlear implants. Bone Conduction Aided Testing has been aided by a bone conduction device. No Response No response from subject at identified frequency. No Response No response from subject at identified frequency. Retrocochlear A form of sensorineural hearing loss in which the lesion is proximal to the cochlear. Other The test environment was not a booth that meets audiometric standards for ambient noise inside the booth. Background Noise The amount and nature of noise in the environment that may influence the test results. Not Clinically Significant The background noise is not clinically significant. Clinically Significant The background noise is clinically significant. Pulse Tone The test stimulus is a pulse tone. Average Record of the average measured results from more than one test. For example, the average of the 3000Hz to 6000Hz measurements in a Hearing Conservation or Industrial Audiometry Assessment. Other data elements, such as Sc may not be relevant. Confounding Factors Description of factors, not recorded elsewhere, that may influence the threshold measurements. For example: noise exposure prior to test.