ARCHETYPE Audiogram Result (openEHR-EHR-OBSERVATION.audiogram.v2)

ARCHETYPE ID	openEHR-EHR-OBSERVATION.audiogram.v2
Concept	Audiogram Result
Description	Record of measurements of hearing acuity using an audiometer and their clinical interpretation.
Use	Use to record measurements and related findings of hearing acuity for one ear at a time or both ears simultaneously. 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 test measurements for the following tests: Pure Tone Audiometry; Play Audiometry; Auditory Brainstem Response; Automated 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.
Misuse	Not to be used to record other hearing tests. Use other archetypes as appropriate, for example OBSERVATION.tympanogram.
Purpose	To record measurements of hearing acuity using an audiometer and their interpretation by a clinician.
References
Copyright	© openEHR Foundation
Authors	Author name: Heather Leslie Organisation: Ocean Informatics Email: heather.leslie@oceaninformatics.com Date originally authored: 2012-10-10
Other Details Language	Author name: Heather Leslie Organisation: Ocean Informatics Email: heather.leslie@oceaninformatics.com Date originally authored: 2012-10-10
Other Details (Language Independent)	MD5-CAM-1.0.1: 34AFB409D6B9BC853F26CECFA6F185F4
Keywords	hearing, test, audiogram, audiometry, acuity
Lifecycle	CommitteeDraft
Language used	en
Citeable Identifier	1013.1.1316
state
Aided	Aided: The test has been conducted with the patient using a form of auditory assistance, such as a hearing aid or cochlear implant. at0029::Aided [The test has been conducted with the patient using a form of auditory assistance, such as a hearing aid or cochlear implant.] at0030::Unaided [The test has been conducted without the patient using any form of auditory assistance, such as a hearing aid or cochlear implant.]
Pre-test Conditions	Pre-test Conditions: Identification of whether the subject was exposed to a quiet environment for a specified period prior to testing. at0124::Pre-test quiet [Test preceded by a quiet period.] at0125::No pre-test quiet [Test not preceded by a quiet period.]
events
Any event	Any event: Any unspecified point in time or interval event.
protocol
Masking	Masking: Presentation of a frequency masking stimulus to the non-test ear to more accurately determine hearing thresholds in the test ear. at0022::Unmasked [No masking was used during the test.] at0021::Masked for bone conduction [Masking for bone conduction was applied to the non-test ear.] at0118::Masked for air conduction [Masking for air conduction was applied to the non-test ear.]
Presentation	Presentation: Presentation of the test stimulus to the test ear. For example, noting the cooperation of the patient or the method used.
Air Conduction	Air Conduction: The indirect transmission of the test stimulus to the inner ear through the atmosphere, via the auditory canal and inner ear structures. at0110::Freefield [The stimulus is presented via loudspeaker.] at0111::Insert earphone [The stimulus is presented via inset earphones.] at0112::External earphone [The stimulus is presented via external earphones.]
Bone Conduction	Bone Conduction: The direct transmission of the test stimulus to the inner ear via the cranial bones. at0114::Mastoid [The posterior part of the temporal bone, including the mastoid process.] at0115::Forehead [Area of the head bounded by the normal hairline, eyebrows and the temples on either side.]
Test Environment	Test Environment: The space and conditions in which the audiometric test is administered. at0076::Audiometric booth [Sound-treated room designed to attenuate nominal outside noise.] at0077::Minimal background noise [Non sound-treated room with minimal background noise.] at0078::Moderate background noise [Non sound-treated room with moderate background noise.] at0079::High background noise [Non sound-treated room with high background noise.]
Test Stimulus	Test Stimulus: Identification of the frequency-specific stimulus used in measuring the hearing threshold. at0035::Tone burst [The test stimulus is a tone burst.] at0036::Click [The test stimulus is a click.] at0080::Modulated tone [The test stimulus is a modulated tone.] at0081::Pure Tone [The test stimulus is a pure tone.] at0082::Broadband noise [The test stimulus is a broadband noise.] at0083::Pink noise [The test stimulus is pink noise.] at0084::Narrowband noise [The test stimulus is narrowband noise.]
Click Stimulus Specification	Click Stimulus Specification: Identification of parameters specifying a click stimulus.
Onset Ramp	Onset Ramp: Time over which the stimulus grows to full amplitude. Property: Time Units: millisec
Offset Ramp	Offset Ramp: Time over which the stimulus depletes to zero amplitude. Property: Time Units: millisec
Total Duration	Total Duration: Total duration of the click stimulus. Property: Time Units: millisec
Threshold Determination Protocol	Threshold Determination Protocol: Protocol used to measure the hearing threshold.
Step Size	Step Size: The step size (in decibels) of the change in the stimulus intensity. at0095::1 dB [Step size of one decibel.] at0096::5 dB [Step size of five decibels.] at0097::10 dB [Step size of ten decibels.] at0098::20 dB [Step size of 20 decibels.]
Direction	Direction: The direction of change in the stimulus intensity. at0100::Descending/Ascending [Initial direction of change of the stimulus intesity is descending, followed by ascending.] at0101::Ascending/Descending [Initial direction of change of the stimulus intensity is ascending, followed by descending.]
Audiometer	Audiometer: Details of audiometer used to conduct the test. Include: openEHR-EHR-CLUSTER.device.v1 and specialisations
Earphones	Earphones: Details of earphones, either insert or external, used to conduct the test. Include: openEHR-EHR-CLUSTER.device.v1 and specialisations
Test Modifications Required	Test Modifications Required: Narrative description of any modfications to the standard methodology required to enable successful completion of the test.
Calibration Reference dB	Calibration Reference dB: Scale used for acoustic calibration check. at0090::db SPL [The sound pressure level scale was used.] at0091::dB HL [The hearing level scale was used.] at0092::dB nHL [The normal hearing level scale was used.]
Screening Assessment Pass Criteria	Screening Assessment Pass Criteria: Criteria used to determine a screening assessement pass.
Stimulus Type	Stimulus Type: Type of stimulus used. at0104::Tone [A tone stimulus was used.] at0105::Click [A click stimulus was used.]
Stimulus Level	Stimulus Level: Identification of the hearing threshold level used to determine a screening assessment pass. Property: Loudness Units: -10.0..120.0 dB Limit decimal places: 0 Assumed value: 0.0dB Limit decimal places: 0
Stimulus Frequency	Stimulus Frequency: Identification of the stimulus frequency used to determine a screening assessment pass. Property: Frequency Units: 0.125..16.0 kHz Limit decimal places: 3 125.0..16000.0 Hz Limit decimal places: 0 Assumed value: 125.0Hz Limit decimal places: 0
Comment	Comment: Additional narrative about the protocol for the audiogram not captured in other fields. For example, the cooperation of the subject or the method use for testing.
data
Test Result Name	Test Result Name: Identification of the Audiometry test performed. Coding with a terminology is preferred, where possible. Applicable tests include: Pure Tone Audiometry; Play Audiometry; Auditory Brainstem Response; Automated Auditory Brainstem Response; and Visual Reinforcement Orientation Audiometry.
(Test Result)	(Test Result): The audiometry test result which can be recorded per ear or for both ears simultaneously. Runtime name constraint: at0127::Left Ear Test Result [Test results for the left ear solo!] at0128::Right Ear Test Result [*] at0129::Binaural Test Result [REsult for bothies.]
Measurement	Measurement: The measured frequency/threshold level pair.
Frequency	Frequency: The stimulus frequency tested. Property: Frequency Units: 125.0..16000.0 Hz Limit decimal places: 0 0.125..16.0 kHz Limit decimal places: 3 Assumed value: 0.125kHz Limit decimal places: 3
Threshold Level	Threshold Level: The stimulus intensity at threshold for the test frequency. Property: Loudness Units: -10.0..120.0 dB Limit decimal places: 0
No Test Result	No Test Result: No test result is available for the test ear. Record as True if the clinician was unable to record a result for the test ear. Allowed values: {true}
Reason for No Test Result	Reason for No Test Result: Reason why no result is available for the test ear. For example, patient was not cooperative; patient was not capable; ran out of time.
Screening Assessment	Screening Assessment: Interpretation of a series of audiometric measurements, for purposes of screening assessment. at0052::Pass [The test was passed, based on screening criteria.] at0053::Fail [The test was failed, based on screening criteria.]
Hearing Threshold Interpretation	Hearing Threshold Interpretation: Interpretation of a series of audiometric measurements for purposes of hearing threshold assessment.
Pure Tone Average	Pure Tone Average: The calculated average pure tone hearing threshold according to specifed averaging criteria.
dB Average	dB Average: The average pure tone threshold according to the specified averaging criteria. Property: Loudness Units: -10.0..120.0 dB Limit decimal places: 1 Assumed value: 0.0dB Limit decimal places: 1
Criteria	Criteria: The criteria on which the Pure Tone Average is calculated. at0062::3 frequency average [The pure tone hearing threshold is calculated using 0.5, 1 and 2 kHz.] at0063::4 frequency average [The pure tone hearing threshold is calculated using 0.5, 1, 2 and 4 kHz.]
Type of Loss	Type of Loss: Identified type of hearing loss for the test ear, based on all measurements. at0068::Conductive [Hearing loss caused by blockage or damage in the outer and/or middle ear.] at0067::Sensorineural [Hearing loss that is caused by damage to, or malfunction of, the cochlea or auditory nerve.] at0066::Mixed [Hearing loss that is caused by a combination of conductive problems in the the outer and/or middle ear plus sensorineural problems in the cochlear and/or auditory nerve.] at0069::Indeterminate [It is not possible to determine the exact type of hearing loss.]
Clinical Interpretation	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.
Articulation Index	Articulation Index: An algorithm to predict the amount of speech that is audible to a patient with a specific hearing loss. Unitary Numerator: 0.0..1.0 Assumed value: 0.0 Assumed value: false
Symmetry of Loss	Symmetry of Loss: An interpretation about the symmetry of hearing loss, based on all hearing acuity measurements for both ears. at0072::Symmetrical [The hearing loss is symmetrical.] at0073::Asymmetrical [The hearing loss is assymmetrical.]
Overall Interpretation	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.
Test Result Image	Test Result Image: Digital representation of the entire result. image/cgm, image/gif, image/png, image/tiff, image/jpeg
Comment	Comment: Additional narrative about the test results and intepretation not captured in other fields.
Other contributors	Stephen Chu, NEHTA, Australia (Editor) Kerrie Lee, Ngaanyatjarra Health Service, Australia (Editor) Heather Leslie, Ocean Informatics, Australia (Editor) Kathy Currie, Program Leader, Hearing Health, Northern Territory Health
Translators