Audiometer

Audiometer obtains threshold and uncomfortable levels in dB HL by generating pure tone signals through the patient's hearing aid(s), also known as In-situIn-situ(From the Greek word ’in place’.) Audiometry. The thresholds obtained are specific to the acoustic coupling of the devices and the environment in which the test was completed and are not to be considered a replacement for diagnostic results. Audiometer is used during the initial fit to assist you in more accurately programming the device(s). Any In-situ adjustments can be applied to a Best Fit or Target Match. If applied, the word 'In-situ' appears above the response graph to indicate In-situ data is being used to calculate the targets when viewing the frequency response curve. Audiometer is available for all products that support In-situ Audiometry.

Audiometer is available during a live or remote programming fitting, or simulation. If an audiogram is stored in the hearing aid(s) or an audiogram exists for the patient in Noah or PatientBase, it automatically defaults. If there's a conflict between the audiogram in the hearing aid and Noah or PatientBase, the audiogram selected to use automatically defaults. A speech spectrum overlay can be displayed over the audiogram to illustrate the sounds heard.

In-situ frequency points can be added, changed, deleted, reset, or marked as no response, and the response curve can be reset back to the original audiogram at any time.

1. Connect and select the desired hearing aid(s) to obtain threshold and uncomfortable levels via Connect.

   Note:  In a live fitting, the hearing aid(s) must be in the patient's ear(s).

2. Click Connect.
3. Click Audiometer from the Left Navigation Menu.

   Note:  The hearing aid(s) is automatically muted. Audiometer is a monaural function and by default, starts on the right ear in a binaural fitting. Click to adjust the left ear first if desired. If fitting CROS/BiCROS devices, only the receiver aid can be adjusted; therefore, the side cannot be selected. The blue shaded region represents the testing range for the hearing aid. The size of the blue shaded region will vary based on the hearing aid's bandwidth and acoustic configuration. Click for more information. A or indicates the current point selected on the graph. The audiometer symbols, stored in the database or hearing aid, are displayed on the disabled graph and greyed out.

4. Check Display Speech Spectrum to display a gray shaded region representing conversational speech if desired.
5. Clickto talk to the patient if desired.

   Note:  This button is only enabled during a live fitting. The hearing aid's microphone(s) is unmuted and all Audiometer functions are disabled except Display Speech Spectrum.

6. Talk to the patient.
7. Clickwhen done talking to the patient.

   Note:  This button is only enabled if talk to the patient was selected in step 5 during a live fitting. The hearing aid's microphone(s) is muted and all Audiometer functions are enabled.

8. Click on the audiometric symbol to test or click , , , or to navigate to the point to test by increasing or decreasing the level and/or frequency.

   Note:  Testing is only allowed within the blue shaded region. If the level or frequency is outside the blue shaded region, the affected navigational button(s) is disabled.

   Note:  Audiometer automatically defaults to threshold testing. To bypass and test UCLs, continue at step 12.

9. Check or uncheck Pulsed to present a pulsed or steady tone.

   Note:  This checkbox is only available during a live fitting for select products. If checked, a minimum of 3 pure tone signals will be presented for 256 milliseconds, each with 192 milliseconds of silence between tones. If unchecked, 1 pure tone signal will be presented for at least 256 milliseconds.

10. Click and hold the Presentation button or press and hold the Spacebar for the desired presentation time, and a blue frame will flash or display around the response graph until the button or Spacebar is released.

    Note:  This button is only enabled during a live fitting.

    Tip:  Right click on the point and click Present Tone. The minimum tone duration will be presented.

11. Repeat steps 8-10.

    Note:  Once In-situ thresholds are obtained, additional red o's or blue x's appear on the graph.

    Tip:  To mark a point no response, right click on the point and click No Response. The' no response' indication is removed if the level is changed for a no response point. To reset a point, right click on the point and click Reset Point. If the point exists in the original audiogram, it's reset back to its original point. If the point doesn't exist in the original audiogram, it's deleted. To delete a point, right click on the point and click Delete Point. To delete the In-situ test results, click Reset or right click on the graph and Reset Curve.

12. Click UCL to obtain uncomfortable levels if desired.

    Note:  A or indicates the current point selected on the graph.

13. Repeat steps 5-11.

    Note:  Once In-situ UCLs are obtained, additional red u's or blue u's appear on the graph.

14. Click to adjust the left ear, if applicable, and repeat steps 5-13.

    Note:  Click to adjust the right ear if the left ear was adjusted first.

15. Click Best Fit In-situ to update targets and apply a new best fit, or click Update Targets In-situ to update targets only. A dialog box asks which hearing aids to update if adjustments were made to both devices.

    Note:  These buttons are only enabled if an In-situ adjustment was made during a live fitting. If only one hearing aid is adjusted, the dialog box does not appear, and the update is automatically applied.

    Note:  If the hearing aid(s) has not been updated and a different Pro Fit screen is selected, a message to apply a best fit to the hearing aid(s) displays. If only one hearing aid was adjusted, click Yes to update or click No to cancel the update. If both hearing aids were adjusted, continue at step 16.

16. To update only the right or left hearing aid, uncheck Right or Left.

    Note:  If the hearing aids were not updated and a different Pro Fit screen was selected, to update only the right or left hearing aid, uncheck Best Fit Right or Best Fit Left.

17. Click OK to update the selected hearing aid(s).

    Tip:  Click Cancel to cancel the update.

    Note:  If the hearing aids were not updated and a different Pro Fit screen was selected, click OK to update the selected hearing aid(s) or click Cancel to cancel the update.

    Note:  If the hearing aid(s) was not updated and a different Pro Fit screen was selected, all In-situ adjustments are retained; therefore, if this screen is accessed later during the same fitting session, the hearing aid(s) can still be updated if desired.