Filling in audiogram fields manually

Manually recording pure tone testing results is a simple process of clicking on the appropriate icon in the palette of standard clinical symbols and then using the icons to fill in the graph.

The following procedure will explain the basic steps for filling out the audiogram manually. Variations such as entering masking values and recording comments will be described afterward. (For instructions on how to upload audiogram data directly from a serial port see Working with an audiometer or tympanometer.)

From the palette on the right side of the Audiogram form, click on the icon that corresponds to the ear being tested and the type of test.

Move the cursor over the graph, and click on the hearing level for the first test frequency.
An icon appears on the graph.

Continue filling out the graph for each frequency based on the testing of that ear.
Note that AudBase automatically connects the icons with lines. You can show or hide the lines depending on your preferences. (See Display options.)

Click on the icon for the second test ear, and repeat the process of filling out the graph.

The palette uses special symbols for Sound Field and Comfort Level testing. All unaided soundfield types are available in the pop-up on the left. You can select the type of aid used in the Sound Field from the pop-up list to the right of the palette. The icon changes to reflect the nature of the aid, for instance AR stands for Aided, right and CB stands for Cochlear Implant, bilateral. All combinations of Aided, Hybrid and Cochlear Implant are available in the pop-up on the right. Clicking the No Response box under the palette and selecting the appropriate icon records a value using the conventional No Response symbols

Bone conduction tests

The default icons for unmasked bone conduction tests allow you to specify both right and left side mastoid testing. You can select specified mastoid testing, unspecified mastoid testing, or forehead testing from the pop-up list to the right

Note: If you specify right and left values and later decide to use an unspecified value for a given frequency, the original right and left values are automatically erased to protect against invalid data.

Masking values

Once you have filled in a masked value on the audiogram, you can record effective masking values for the non-test ear using the table below the graph on the PTA tab. The table is divided into columns that roughly line up with the frequency lines on the graph, and has rows for air and bone conduction testing.

On the PTA tab of the Audiogram form, fill in the graph with the appropriate icons.

In the masking values table below, find the field that corresponds to the masked test result on the graph. The cursor changes to an I-bar when it passes over a box that corresponds with a valid frequency, test type, and ear.

Enter a value in the field.
If you enter an invalid number and then leave the cell, an alert appears reminding you that values must be within the valid range.

Note: Masking value details are automatically converted to a detailed text format which is displayed on the Notes tab of the form. The display field allows you to copy and paste information into your Notes field so you can use it later as search terms in the database (see Searching).

An example entry is shown below, indicating a Pure Tone Masking Value of 30 dB for the right ear at 500 Hertz:

"AMR" stands for air masked, right; another example would be "BUL" for bone unmasked, left. The ability to choose different frequency ranges (e.g. for a high frequency audiogram) is reflected in the complete field name: 500 Hertz or Special Frequency number three (SpF03).

Entering comments

To attach a comment to an icon on the graph, click the Comment box under the palette before placing an icon. The pop-up list next to the box gives you three options. Selecting "Comment" attaches a "C" to the icon, indicating you have included a comment on the Notes tab of the form. Two frequent comments are "Pressure" and "Vibrotactile." These comments are included directly in the pop-up lists and, if selected, the appropriate letter will be attached to the icon.

Tab Entry Form

AudBase allows you to select a tab entry form instead of the graphics form. You can choose the form you want to use for new audiograms in Preferences (see Audiology (1)).

When entering values directly into the tab entry form two modifications can be performed. To convert a threshold to a No Response value tab out of the field and then shift-click on the field. The displayed threshold will change to a red color signifying a No Response threshold. Bone transducer type can be specified for a bone field by selecting from the Bone Transducer pop-up when the entry cursor is in the appropriate field. If an unspecified bone type is chosen, the entered value will be placed in the complementary field for the opposite ear as well.

Two preference items can be specified by the user for the tab entry form (see AudBase). Round pure tone entries to the nearest 5 dB will round all entry values appropriately. This option should be turned off for entering smaller dB increments. This setting does not affect values downloaded from an audiometer. Display NR values as `NR' text will display NR values appropriately on locked forms and printed tabular forms.

Pure Tone Average

AudBase automatically calculates pure tone averages (PTAs) for monaural and sound field testing, displaying them at the bottom of the PTA tab. The default averages are based on three frequencies: 500, 1000, and 2000 Hertz. AudBase allows you to request calculations for two-frequency averages. This can be valuable, for example, if you wish to record a PTA for a subject whose test includes No Response values. To use a two-frequency calculation, click in the dBHL box next to the appropriate ear and test type, and choose your frequencies from the pop-up list. If you choose to record both masked and unmasked values, the program preferentially uses the masked values in calculating a PTA.

Setting Frequency Range

The default Audiogram form covers the standard frequency range from 125 Hz to 12000 Hz. If your audiometer is capable of testing special frequencies (8000 Hz to 20000 Hz for example), you can select the frequencies for entering your special frequency audiogram by clicking Frequency Range. The entry form will change appropriately.

The special frequency data values are stored in the pure tone air conduction fields. Because the special frequency values differ between audiometers, the data fields used to store the special frequency data are identified generically (for example, PureTone_AUR_SpF01 is the first special frequency field in the audiogram). The corresponding key to the frequency values is automatically specified when you select the Frequency Range button and stored in the SpecFrequencyAudiogram_FieldHz field.

Display options

You have broad control over the display of each audiogram, both on-screen and in print. For example, you can choose to show all or part of the test results, vary icon style, and include an HTLA confidence level for comparisons or the Speech Banana.

The following is a quick summary of the various options in the Drawing menu that appears on your screen with an audiogram. You can also set default display options using the Preferences form (see Audiology (1)).

· Line Drawing: Show or hide lines connecting air, bone, or sound field test values by clicking the appropriate menu item. Clicking the "Include No Response" or "Include P/V comments" will connect the corresponding icons, which normally interrupt the line.

· Masking Status: Show or hide masked or unmasked values. Clicking "Masked Preferred" suppresses unmasked values when a masked value is available.

· Side, Type, Soundfield Subtypes and Modifiers: Show or hide the various items depending on your selection. Display of soundfield subtypes can be controlled individually under the Soundfield Subtypes submenu or they can be controlled as a group under the Type submenu (SndFld, unaided and SndFld, aided).

· Icon Style: Allows you to choose thin or thick icons, for on-screen appearance and for printing.

· HTLA background: Gives you 10 options for display of HTLA confidence limits as a background to your subject entries on the graph. This option only works if you have entered a gender and age for the subject in the Subject Info form.

· Speech Banana: Show or hide the Speech Banana on the audiograms.

Note: Drawing options are saved with the audiogram. If you want to print or display an audiogram record with options different from the saved ones, you can change the settings temporarily while the record remains locked. The changes will not be saved unless the record is unlocked and then resaved.

SRT/SAT tests

Speech reception and awareness thresholds can be entered on the SRT/SAT tab of the Audiogram form. You can either enter data directly in 1-dBHL increments or use a pop-up list to enter data in 5-dBHL increments depending on how you set your preferences (see Audiology (1)). Each column within the threshold tables contains a field for dBHL values and a field for masking values.

The entry control pop-up on the left side of the form allows you to select entry fields for "SRT, no babble", "SRT, babble" and "SAT". To enter dBHL values, click in the appropriate box and enter the dBHL value. If you enter an invalid number in the dBHL field and then leave the cell, an alert appears reminding you that values must be within the valid range. Enter CNT for "could not test". If the condition was not done, leave the dBHL field blank.

To enter masking values, click in the small white box to the left of the dBHL value field and fill in the dialog that appears. An asterisk (*) appears in the box to indicate the presence of a masked value. Note that detailed information on the masking values is automatically displayed on the Notes tab of the form, in a text field that allows you to copy and paste information into the Notes field. The Notes field allows you to record and store text that you can use later as search terms in the database (see Searching).

You can enter stimulus information by clicking on the Spondee Stimulus button on the bottom of the form. The Select Spondee Stimuli form appears.

Click on the tested stimuli in the box on the left, drag it into the box on the right, and drop it in the appropriate test condition. If you drop it on a parent item such as "SRT" the tested stimuli is added to all the dependent tests. If you drop the stimuli into the wrong condition, drag the stimuli to the trash icon or to the appropriate condition. LV stands for "live" and REC stands for "recorded." (To modify the stimulus list, see Modifying lists.) Click on OK.

Note: You can specify default settings for the Select Spondee Stimuli form (see AudBase). You can override default settings by clicking on any default stimulus conditions that appear in the box on the right and dragging them to the trash icon.

The Spondee Stimuli button appears in italics to indicate that there are stimuli entered. If you specify default settings for the Select Spondee Stimuli form, the button will appear in italics whenever you open a new Audiogram.

Word Recognition tests

The Word Rec tab of the Audiogram form records and graphs Word Recognition testing data as you enter it. Percent correct values can be typed into the fields for monaural, binaural (aided and unaided), and sound field tests (aided and unaided). You can switch between binaural under phones (Bi), soundfield binaural aided (S), and soundfield unaided (S) tests by clicking on the pop-up list in the center column of the table.

The entry control pop-up on the left side of the form allows you to select entry fields for "No babble" and "Babble".

If you enter an invalid number in either the percent correct field or the dBHL field and then leave the cell, an alert appears reminding you that values must be within the valid range. Enter CNT for "could not test". If the condition was not done, leave the dBHL field blank. A percent correct calculator can be opened by shift-clicking on a percentage field which the cursor is not currently in. The calculated value will be entered into the field when the calculator is closed.

As you enter each value, AudBase adds points to the graph on the right side of the form, allowing the clinician to quickly discern such things as rollover phenomenon. You can control which graph appears by clicking on the header above each value field. For instance, the small graph shown above is the monaural, right graph. These graphs can be printed later (See Printing audiograms).

To enter masking values, click in the small white box to the left of the percentage field and fill in the dialog that appears. An asterisk (*) appears in the box to indicate the presence of a masked value. Note that masking values details are automatically displayed on the Notes tab of the form in a text field that allows you to copy and paste information into the Notes field. The Notes field allows you to record and store text that you can use later as search terms in the database (see Searching).

You can enter test type information by clicking on Word Rec Type above the table. The Select Word Rec Types form appears.

Click on the Word Recognition Type in the box on the left, drag it into the box on the right, and drop it in the appropriate test condition. If you drop it on a parent item such as "SRT" the tested stimuli is added to all the dependent tests. If you drop the stimuli into the wrong condition, drag the stimuli to the trash icon or to the appropriate condition. LV stands for "live" and REC stands for "recorded." (To modify the Word Recognition Type list, see Modifying lists.) Click on OK.

Note: You can specify default settings for the Select Word Rec Types form (see AudBase). You can override default settings by clicking on any default Word Recognition Type conditions that appear in the box on the right and dragging them to the trash icon.

The Word Rec Type button appears in italics to indicate that there is an associated record. If you specify default settings for the Word Rec Types form, the button will appear in italics whenever you open a new Audiogram.

If a related SAT\SRT\Word Recognition record has been previously created, you can connect that tympanogram to your audiogram record.

Click on the Select Related SAT\SRT\Word Recognition button to choose between available

records.
The list of tympanograms associated with the subject appears as a Related record.

Select the tympanogram related to this audiogram and click on OK. If there are no tympanograms listed, or the subject's most recent one is missing, you need to update the appropriate records for this subject. (See Tympanogram).

The tympanogram information appears. AudBase automatically enters the Tympanogram Date.

Note: An audiogram record may only be related to a single SAT\SRT\Word Recognition record. However, a SAT\SRT\Word Recognition record may be related (using the SAT\SRT\WR tab on the Subject Studies form) to multiple audiogram records.