COMMUJNICATION
Contents
1. Jul 9 2002 Sheet 3 of 8 US 6 416 482 lt gt ME 222 3 a lt 2 22 82 IO Ge o cr oagQ dogco HX TO espa e S SQ P9 0 P8 2 o L 1A 210531 2 1 27 RESET TEX EN I 28 DO CLOCK 291 181 av iG TE 1 CP XD 3 1 pn 2 24 ED ATS 23 17 165 1 PO DSA l 4 620126 V _ SVTo 0 OUTS U10 01 r m dE OPE RE I GO 5V Rope 6104 4 v 2105 G2 3 d B slo CLK S 01032 CLK 1154 1 536 2 19 ale 1 I 23 WR CLK 2 6 12 I 45V 1 V Ince m en ge eom em m 34 00 dig 3102 4103 39 D4 28195 728106 O 2207 Wa O T RD NK 020 E ELE EM BRESET pga PBS pr 3 LLL C oV p i P 5V C25 8 5 br s L d U15 Fig 28 C24 PRIOR ART Y 9 57 pns OG o LOS cNi im olo xxx x 15 a SPs EW s HANDSWITCH P7 U S Patent Jul 9 2002 Sheet 4 of 8 US 6 416 482 B1 5V Q U20 15 ap 28558855 9 5 14 3 B0R3R211 R7 R8 R 25 11k 31 78k 31 18K3100K 1 1 1 1 5V L 1 R25 Y Yi ns R26 10K YO 8j 1213456 HEADPH 68 70 JACK 48 rig 2C PRIOR ART U S Patent Jul 9 2002 Shee2. 55 60 65 4 steps of outputting generating the test tone storing gener ating the analog sound and switching BRIEF DESCRIPTION OF THE DRAWINGS FIG 1 is a functional block diagram of a conventional audiometer FIG 2 is a detailed schematic of a typical audiometer corresponding to the functional block diagram of FIG 1 FIG 3 is a schematic of a talkover card for use with the audiometer of FIG 2 FIG 4 is a block diagram of an audiometer interfaced with a personal computer for multimedia automation of audiometer testing FIG 5 is a functional block diagram of an audiometer interfaced with a multimedia personal computer FIG 6 is a schematic of the personal computer connection with the talkover card of FIG 3 to provide multimedia automation of audiometer testing and FIG 7 is a flow diagram of a protocol for audiometric testing utilizing the multimedia features of the embodiments of the present invention to automate the test process DESCRIPTION OF THE PREFERRED EMBODIMENTS Referring to FIG 1 a functional block diagram of a conventional audiometer 2 may be described Although the following discussion primarily addresses embodiments of the present invention employed for an audiometer the embodiments have varied application in a wide variety of medical and diagnostic instrumentation All those applica tions are intended as included within the scope of the invention Also the following describes var
3. Jun 27 2006 Reexamination Certificate for 6 416 482 63 51 52 58 56 JP Patent No Issued Appl No Filed Notice Jul 9 2002 09 139 858 Aug 25 1998 This patent claimer is subject to a terminal dis Related U S Application Data Continuation of application No 08 639 694 filed on Apr 29 1996 now Pat No 5 811 681 Int Cl A61B 5 00 2006 01 US e L a asa 600 559 Field of Classification Search None See application file for complete search history 3 809 811 4 489 610 4 847 763 4 862 505 4 933 873 5 197 332 5 303 327 References Cited U S PATENT DOCUMENTS A A A A A A A 5 1974 12 1984 7 1989 8 1989 6 1990 3 1993 4 1994 Delisle et al Slavin Moser et al Keith et al Kaufman et al 704 270 Shennib Sturner et al FOREIGN PATENT DOCUMENTS 6 175817 12V 6 1994 R4 102 2M 100PF JP 7 308310 11 1995 OTHER PUBLICATIONS Willam Dermant Holding To the Copenhagen Stock Exchange Announcement No 2002 06 pp 1 3 Office translation of JP 6 175817 published Jun 24 1994 entitled Multimedia Hearing Test and Compensation 14 pages Benson Medical Instruments Company Computer Con trolled Audiometer Model CCA100 Document Version 1 30 Dec 13 1994 45 pages Benson Medical Instruments Company Computer Con trolled Audiometer Model CCA100 Do
4. a completion of a current test or a test error outputting sound representative of the sound signals after the step of first switching second switch ing the audiometer output to test tones after the step of outputting and outputting test tones until the next step of first switching Another embodiment of the invention is a multimedia audiometer The multimedia audiometer comprises means for outputting sound signals generated from digital information means for outputting test tones means for switching between the means for outputting sound signals and the means for outputting test tones and means for US 6 416 482 B1 3 controlling the means for switching the means for control ling being communicatingly connected with the means for switching The means for switching is communicatingly connected with the means for outputting sound signals and the means for outputting test tones Yet another embodiment of the invention is a multimedia audiometer The multimedia audiometer comprises a computer a tone generator and a switch connected with the computer and the tone generator The switch selectively causes either the tone generator or the computer to output sound waves and the computer controls the switch Another embodiment of the invention is an audiometer The audiometer comprises a processor a memory commu nicatingly connected with the processor for storing digital data a sound wave generator for generating analog sound s
5. PUBLICATIONS USAEHA Hearing Evaluation Automated Registry System HEARS USAEHA Technical Guide No 167A Audiom eter Operation Manual Feb 1991 pp 1 1 to 11 14 plus Appendix A RA400 Microprocessor Audiometer Operation Manual 78835A Sep 1983 Tracor Instruments pp 1 1 to 9 1 Rion Co Ltd 44 75 Audiometer Operation Manual Excerpt from Operation Manual 10 pages including English translation Japan No 22920 95 10 Oct 1995 Virtual Corporation Virtual Model 320 Clinical Audiometer User Manual 1988 148 pages cited by examiner US 6 416 482 Cl 1 EX PARTE REEXAMINATION CERTIFICATE ISSUED UNDER 35 U S C 307 THE PATENT IS HEREBY AMENDED AS INDICATED BELOW AS A RESULT OF REEXAMINATION IT HAS BEEN DETERMINED THAT Claims 1 14 are cancelled ONLY THOSE PARAGRAPHS OF THE SPECIFICATION AFFECTED BY AMENDMENT ARE PRINTED HEREIN Column 10 lines 43 53 After the computer has selected and output 306 the desired sound signals to the basic audiometer 200 and sig nals have been delivered to the test subject as sound waves through the earphone speakers 50 the computer 102 again 15 20 2 may control 308 the basic audiometer 200 The control 308 at this instant may trigger the relay 64a to close open the switches 66a and the relays 66b shown in FIG 2 to open close the switches 66b respectively The control 308 then causes the basic audiometer 200 to generate 310 a series of test
6. and connectivities of the detailed schematic Referring now to FIG 3 a detailed schematic is provided of the talkover card 8b of the conventional audiometer 2 The talkover card 8b comprises a fixed gain operational amplifier 60 A voice microphone 62 is an input to the amplifier 60 Other common electronic elements such as for example resistors capacitors and others may be included in the circuitry of the talkover card 8b The amplifier 60 is connected to the input to the earphone jack 48 of the audio circuitry 6 of the conventional audiometer 2 shown in FIG 1 by a relay 64a When a human test administrator wishes to deliver voice sounds rather than test tones to a test subject wearing the earphone speakers 50 plugged into the earphone jack 48 shown in FIG 1 the test administrator causes the relay 64a to be thrown The test administrator by such action simultaneously causes the conventional audiometer 2 to interrupt the test then in progress discontinuing test tone generation Referring to FIGS 1 3 in conjunction the relay 64a when so thrown connects the amplifier 60 across switches 66a to the input to the earphone jack 48 In particular electrical connector 68 passes the voice signals from the amplifier 60 to the earphone jack 48 for delivery through the right ear speaker of the earphone speakers 50 and electrical connector 70 similarly passes the voice signals to the left ear speaker When relay 64a results in closure o
7. eter 2 be modified in certain respects to provide the basic audiometer 200 for multimedia automation of testing as hereafter described Referring now to FIG 5 the communications interface 108 and the multimedia input interface 110 connect the computer 102 with the basic audiometer 200 to form the multimedia audiometer 100 as shown in functional block form A serial input output port not shown in detail of the computer 102 may directly connect via the communications interface 108 with the RS232 port 8a of the basic audiometer 200 A multimedia output port not shown in detail of the computer 102 may directly connect via the multimedia input interface 110 with a multimedia talkover card 1185 similar to the talkover cord 8b shown in FIG 3 of the conventional audiometer 2 The multimedia output port of the computer 102 may for example be a port of a sound card not shown in detail from which sound signals are output by the computer 102 Alternatively or additionally other multime dia outputs not shown of the computer 102 for example graphical image or video outputs may connect with the multimedia input interface 110 in similar manner The talkover card 8b shown in FIG 3 of the conventional audiometer 2 configuration has not previously provided a port for connection of the multimedia input interface 110 10 15 20 25 30 35 40 45 50 55 60 65 8 The conventional audiometer 2 may therefore be
8. response input 312 and detection and error determination 314 Once the entire test protocol is completed in the foregoing manner the test is completed 322 The computer 102 may then control 330 the basic audiometer 200 to trigger the relays 64a b to close the switches 66a and to open the switches 66b The control 330 is accomplished in the manners previously described by communications between the computer 102 and the basic audiometer 200 over the communications interface 108 After the control 330 so sets the switches 66a b the computer 102 may further select and output 340 sound signals which sound signals are derived from digital data stored generated or read by the computer 102 The sound signals may travel to the earphone jack 48 and the earphone speakers 50 to deliver final instructions and messages to the test subject Numerous alternatives and variations are possible for the multimedia audiometer 100 For example digital data stored generated or read by the computer 102 may be representative of a wide variety of sounds images video or other multimedia features In certain embodiments the particular digital data may allow the test subject to select any of a number of different languages through which testing is administered Further digital data may be manipulated by US 6 416 482 B1 13 the computer 102 in such a manner that multiple simulta neous tests may be administered There are of course numerous other possibil
9. tones such as for example tones in accordance with the Hughson Westlake procedure or another testing protocol Column 10 lines 54 63 When the switches 66a are closed opened and the switches 66b are opened closed because of the control 308 the test tones generated 310 by the audio circuitry 6 of the basic audiometer 200 are delivered through the earphone jack 48 to the earphone speakers 50 According to the par ticular testing protocol the test subject may respond to the test tones by input 312 via the handswitch 52 connected to the basic 5 audiometer 200 The basic audiometer 200 in cooperation with the computer 102 will detect and deter mine any error 314 of the input 312 response
10. 02 will detect and determine any error 314 of the input 312 response If there is not any error 316 then the basic audiometer 200 may continue to generate successive test tones 320 accord ing to the particular test protocol until the test is completed 322 The successive test tones 320 are generated in the same US 6 416 482 B1 11 manner as previously described That is the basic audiom eter 200 operates to generate test tones 310 delivered to the test subject the test subject responds with input 312 via the handswitch 52 and the audiometer 200 in conjunction with the computer 102 detects and determines 314 any error If an error 318 is detected and determined 314 the computer 102 based on its particular programmed logic determines 324 whether to proceed 326 with the testing to re test 328 or to perform some other function not shown Certain errors that may be encountered during the adminis tration of the test include for example the following No response at 1 kHz Error Code E1 signifies that the test subject is not responding to the test tone The test subject may receive a multimedia sound message generated by the computer 102 and passed through the earphone speakers 50 as to how to take the test for example as follows There has been no response for any tone in the initial test as soon as you hear a tone cut it off by pressing and releasing the hand switch Then the test may be restarted Faile
11. 2 port 8 and a talkover card 8b The RS232 port 8 may conductively connect to the serial I O port 22 to allow communications of the microprocessor circuitry 4 with external peripherals not shown connected with the RS232 port 8a Examples of external peripherals which may connect to the RS232 port 8a may include printers terminals and modems The RS232 standard and suitable connections to ports conforming thereto are gener ally known The other of the common optional elements 8 the talk over card 8b is of particular significance in embodiments of the present invention The talkover card 8b is conductively connected with the audio circuitry 6 of the conventional audiometer 2 between the relay control attenuator 42 and the earphone jack 48 In effect the talkover card 8b serves as a switch to divert input to the earphone jack 48 when desired by a human test administrator not shown The human test administrator may selectively throw the switch and cause the input to the earphone jack 48 to switch from signals from the relay control attenuator 42 representative of test tones to signals representative of the human test administrator s instructions then being voiced Details of the talkover card 8b are hereinafter more fully discussed with respect to FIG 3 Referring now to FIG 2 a detailed schematic of the conventional audiometer 2 of FIG 1 is shown Those skilled in the art will understand and appreciate the electrical elements
12. TEST TONES DELIVERED TO TEST SUBJECT OVER EARPHONES TEST SUBJECT INPUTS RESPONSE VIA HANDSWITCH AUDIOMETER DETECTS RESPONSE COMPUTER DETERMINES AND DETERMINES IF ERROR ERROR HOW TO PROCEED GIVEN AUDIOMETER COMMUNICATES THE ERROR AND DETERMINATION WITH COMPUTER PROGRAMMED LOGIC NO ERROR 318 AUDIOMETER PRODUCES NEXT PROCEED SUCCESSIVE TEST TONES OR TEST 320 COMPLETE 322 TEST COMPLETE COMPUTER CONTROLS BASIC AUDIOMETER TO TRIGGER RELAYS TO CLOSE SWITCHES CONNECTING SOUND PORT AND TO OPENSWITCHES CONNECTING TONES CONTROL SIGINALS PASSED OVER SERIAL INTERFACE 330 COMPUTER SELECTS AND OUTPUTS SOUND FILE S REPRESENTING INSTRUCTIONS CLOSING MESSAGES OUTPUT OVER MULTIMEDIA INTERFACE Pig 7 US 6 416 482 B1 1 MULTIMEDIA FEATURE FOR DIAGNOSTIC INSTRUMENTATION This application is a continuation of application Ser No 08 639 694 filed on Apr 29 1996 and U S Pat No 5 811 681 BACKGROUD OF THE INVENTION The present invention relates to a multimedia interface of a diagnostic test instruction and more particularly to auto mated testing including multimedia derived instruction test monitoring and error response by an audiometer or other medical or diagnostic test instrument Awide variety of medical and diagnostic test instrumen tation is known An example of such instrumentation is an audiometer The audiometer is an electrically activated gen erator of test tones for evaluation of heari
13. US006416482B1 a2 United States Patent ao Patent No US 6 416 482 Braun et al 45 Date of Patent Jul 9 2002 54 MULTIMEDIA FEATURE FOR DIAGNOSTIC 56 References Cited INSTRUMENTATION U S PATENT DOCUMENTS 76 Inventors Leroy Braun 11403 Pollyanna Austin 4 847 763 A 7 1989 Moser et al 364 413 02 TX US 78753 Jack Foreman 806 5 023 783 6 1991 Cohen etal 364 413 02 Yale St Pflugerville TX US 78660 5 239 872 A 8 1993 Meyer Bisch 73 585 5 645 074 A 7 1997 Shennib et al 600 539 Notice Subject to any the a oe p cited by examiner patent 1s extended or adjusted under U S C 154 b by 0 days Primary Examiner John P Lacyk Assistant Examiner Pamela Wingood 74 Attorney Agent or Firm Akin Gump Strauss Hauer amp Feld L L P 57 ABSTRACT This patent is subject to a terminal dis claimer 21 Appl No 09 139 858 A method for automatedly administering an audiometric test 22 Filed Aug 25 1998 includes the steps of controlling an audiometer to selectively w switch the audiometer output between test tones generated Related U S Application Data by the audiometer and sound signals generated from digital information first switching the audiometer output to sound signals when the step of controlling indicates a beginning of a new test a completion of a current test or a test error outputting sound representative of t
14. adapted to provide such port The adapted conventional audiometer 2 is the basic audiometer 200 Referring now to FIG 6 a sound port 120 of a multimedia talkover card 118b for multimedia input to the basic audi ometer 200 may be described The sound port 120 connects with the multimedia input interface 110 so that multimedia outputs of the computer 2 are input to the multimedia talkover card 118b The sound port 120 may include a connector 120a to which the multimedia input interface 110 may be plugged The connector 120a may be attached with two input leads 120b The input leads 120a b may be attached with an audio jack plug 121 The audio jack plug 121 is insertable in an audio jack 122 connected to the amplifier 60 output When the audio jack plug 121 is not inserted in the audio jack 122 the output of the amplifier 60 is shorted prior to the switches 66a When the audio jack plug 121 is inserted in the audio jack 122 however the circuit is completed and the computer 102 connected to the sound port 120 may supply multimedia input to the switches 66a In effect the microphone 62 is substituted with the multimedia input via the sound port 120 All other features of the multimedia talkover card 118b are substantially the same as the features of the talkover card 8b of the prior technology Although the input leads 120b of the sound port 120 are shown as connected with an output of the amplifier 60 in the Figure alternatively the input l
15. at ingly connecting the computer and the basic audiometer Another embodiment of the invention is a diagnostic instrument The diagnostic instrument comprises means for outputting an audible sound means for generating a test tone means for storing a digital data means for generating an analog signal derived from the digital data means for switching an output of the means for outputting between the test tone and the analog signal the means for switching being electrically connected to the means for generating a test tone and the means for generating an analog signal means for processing means for inputting the means for inputting connects the means for processing to the means for outputting and means for communicating the means for communicating connects the means for processing to the means for outputting the means for generating the test tone the means for storing the digital data the means for gener ating the analog signal the means for switching and the means for inputting Yet another embodiment of the invention is a method of performing a diagnostic test protocol The method com prises the steps of outputting an audible sound generating a test tone storing a digital data generating an analog sound derived from the digital data switching the audible sound from the step of outputting between the test tone and the analog signal processing the digital data and controlling the 10 15 25 30 35 40 45 50
16. communications interface and the computer controls the operation of the audi ometer over the communications interface a multimedia input interface communicatingly connecting the computer and the basic audiometer and a communications interface communicatingly connecting the computer and the basic audiometer 13 The multimedia audiometer of claim 11 wherein the computer and the basic audiometer communicate over the communications interface and the computer controls the operation of the audiometer over the communications inter face and wherein the switch comprises a relay and the computer controls the relay in order to switch between the first signal communicated over the multimedia input inter face and the second signal generated by the basic audiometer as the output for the output speaker 14 The multimedia audiometer of claim 13 wherein the computer comprises a sound wave generator for converting a digital information stored by the computer to analog signals in respect of the digital information US006416482C1 a2 EX PARTE REEXAMINATION CERTIFICATE 7074th United States Patent Braun et al 10 Number US 6 416 482 C1 45 Certificate Issued Sep 22 2009 54 MULTIMEDIA FEATURE FOR DIAGNOSTIC INSTRUMENTATION 75 Inventors Leroy Braun Austin TX US Jack Foreman Pflugerville TX US 73 Assignee Maico LLC Eden Prairie MN US Reexamination Request No 90 007 440 Mar 1 2005 No 90 008 066
17. cument Version 1 20 Nov 15 1993 14 pages Benson Medical Instruments Company CCA 00 Operat ing Manual V 1 10 1996 51 pages Benson Medical Instruments Company System 100 Operat ing Manual V 0 96 1995 48 pages Maico Service Manual MA728 and MA728M 56 pages Maico Operating Instrructions Maico MA728M Automatic Computer Audiometer with Maico Warranty Registration 30 pages Tremetrics Medical Instruments Sales Meeting Technical Data and Troubleshooting Nov 1990 35 pages Tracor Instruments Austin Inc RA600 Microprocessor Group Audiometer Service Manual Jun 1985 37 pages Virtual Corporation Virtual Model 320 Clinical Audiometer User Manual 1992 148 pages Continued Primary Examiner Mary Steelman 57 ABSTRACT A method for automatedly administering an audiometric test includes the steps of controlling an audiometer to selectively switch the audiometer output between test tones generated by the audiometer and sound signals generated from digital information first switching the audiometer output to sound signals when the step of controlling indicates a beginning of a new test a completion of a current test or a test error outputting sound representative of the sound signals after the step of first switching second switching the audiometer out put to test tones after the step of outputting and outputting test tones until the next step of first switching US 6 416 482 C1 Page 2 OTHER
18. d to Establish Threshold Error Code E2 signifies that the basic audiometer 200 is unable to establish a hearing threshold level HTL from the response of the test subject The test subject may be instructed based on digital data of the computer 102 for example as follows The audiometer has been unable to establish a threshold listen for the tone and as soon as you hear the tone cut it off by pressing and releasing the hand switch The test may then recommence Hand Switch Error Error Code E4 signifies that the test subject is not releasing the response handswitch 52 The test subject may for example receive the follow ing instructions generated from the digital data stored by computer 102 The audiometer is recognizing the hand switch as being on for a length of time as soon as you hear a tone cut it off by pressing and releasing the hand switch The test may then recommence Response no tone Error Code ES signifies that the test subject has responded at least three times when no tone or stimulus was present A multimedia message for example as follows may be delivered through the earphone speakers 50 The audiometer is recognizing responses when no tone is present as soon as you hear a tone cut it off by pressing and releasing the hand switch The test is thereafter restarted The foregoing error codes multimedia messages and operations are merely example possibilities An example of an ent
19. e test subject does not then respond the level is raised another 5 dB and this is repeated until the subject signals that the tone is heard This entire process is repeated until the test subject has three ascending positive responses at the same level In order to make comparison of hearing quality over time a first test is administered to establish a base line hearing level and later testing under taken at subsequent time intervals provides results for comparison to base line The comparison indicates any hearing loss or other changes over time As with diagnostic and industrial health testing instruments generally audiometers have progressed towards more automation Also as with other instruments however automation of audiometers has typically focused on compilation organization and reporting of test results The automation has not been directed to replacement of a human test administrator or at least the traditional functions of such an administrator by a machine automated process As previously mentioned automation particularly by a machine such as a computer achieves certain advantages In particular the testing may be more uniform among subjects and test periods whereas testing is subject to variation when a human test administrator administers and grades the test Also supplying human test administrators to conduct tests is rather costly Reducing the required number of test admin istrators through further automation o
20. eads 120b could in similar manner connect with inputs to the amplifier 60 or at some other location prior to or after the amplifier 60 Furthermore although the multimedia talkover card 118b is expressly described as a card to the basic audiometer 200 it is to be understood that any other functional elements and circuitry that perform similarly such as for example a relay circuit that switches between the tone generator of the basic audi ometer 200 and the multimedia output from the computer 102 as well as other possibilities are all within the scope of the invention Now referring to FIG 7 in conjunction with FIGS 4 6 operations 300 of the multimedia audiometer 100 and the software driving those operations 300 are discussed When power is supplied to the multimedia audiometer 100 the basic audiometer 200 as well as the computer 102 may perform various set up functions 302 Those set up func tions 302 of the multimedia audiometer 100 for example boot up and initialization of the computer 102 and start up and initialization of the basic audiometer 200 are conven tional The start up and initialization of the basic audiometer 200 may be substantially the same as that of the conven tional audiometer 2 shown in FIG 1 Generally this start up and initialization of the basic audiometer 200 may proceed for example as follows At turn on the basic audiometer 200 presents a first tone and a message appears on the displa
21. ect A new test may be begun for example by pressing a key of the basic audiom eter 200 or alternatively by a similar input to the computer 102 Upon the start of the new test the computer 102 may control the basic audiometer 200 by communication over the communications interface 108 shown in FIGS 4 5 If initial instructions to the test subject are desired the computer 102 may control the basic audiometer 200 over the communications interface 108 shown in FIGS 4 5 This control 304 may trigger the relay 64a and the relays 64b shown in FIG 2 to close the switches 66a and open the switches 66b shown in FIG 2 respectively When the switches 66a are closed and the switches 66b opened in this manner sound signals passed to the sound port 120 from the computer 102 over the multimedia input interface 110 are delivered through the amplifier 69 of the multimedia talk over card 118b and through the earphone jack 48 to the earphone speakers 50 The particular sound signals so passed to the earphone speakers 50 may be derived from digital information stored or generated in or read by the computer 102 The computer 102 may select and output 306 signals representative of the particular digital information If the testing is just beginning the signals so selected and output 306 may be initial instruc tions to the test subject about the test and the testing procedure Of course the particular signals could be repre sentative of vir
22. es some features of the present invention may be employed without a corresponding use of the other features Accordingly it is appropriate that the foregoing description be construed broadly and understood as being given by way of illustration and example only the spirit and scope of the invention being limited only by the appended claims What is claimed is 1 A method for automatedly administering an audiomet ric test comprising the steps of controlling an audiometer to selectively switch the audi ometer output between test tones generated by the audiometer and sound signals generated from digital information first switching the audiometer output to sound signals when the step of controlling indicates a particular condition outputting sound representative of the sound signals after the step of first switching second switching the audiometer output to test tones after the step of outputting and outputting test tones until the next step of first switching 2 The method of claim 1 wherein the particular condition is selected from the group consisting of a beginning of a new test a completion of a current test and a test error 3 A multimedia audiometer comprising means for outputting sound signals generated from digital information means for outputting test tones means for switching between the means for outputting sound signals and the means for outputting test tones the means for switching being communicating
23. f its switches 66a relay 64b results in opening of its switches 66b and vice versa In this manner either voice signals through the talkover card 8b or test tone signals through the audio circuitry 6 at any instant but not both simultaneously is delivered through the earphone speakers 50 As those skilled in the art will understand and appreciate this design of the conventional audiometer 2 has allowed a human test admin istrator to interrupt test tone testing to give instructions error messages and other voice commands The conventional audiometer 2 has required intervention of a human test administrator however by selectively throwing relays 64a b US 6 416 482 B1 7 and speaking into the microphone 62 of the talkover card 8b in order to conduct hearing test with intermittent instructions and messages Multimedia Embodiments Referring now to FIG 4 a multimedia audiometer 100 according to embodiments of the present invention may be described The multimedia audiometer 100 includes a basic audiometer 200 having the basic elements of the conven tional audiometer 2 shown in FIG 1 That is the multi media audiometer 100 is also comprised of the micropro cessor circuitry 4 and the audio circuitry 6 or other similar processing and audio electronics and circuits of the con ventional audiometer 2 shown in FIG 1 The earphone speakers 50 and the handswitch 52 are also interfaced with the basic audiometer 200 Althoug
24. f testing procedures may reduce or eliminate those costs Furthermore test presentation and determined results may vary among human test administrators More standardized and accurate testing may be possible if intervention of a human test administrator is reduced through further automation In addition to those advantages certain automation may provide added advantages for example multi lingual test administration multiple simultaneous different tests multiple simultaneous test subjects visual features and other possibilities Embodiments of the present invention provide advantages of multimedia automation in diagnostic testing employing electronic or other instrumentation The embodiments are particularly suited in the case of an audiometer however numerous other applications of the embodiments are pos sible The above described advantages as well as other advantages are achieved through the embodiments The present invention is thus a significant improvement in the art and technology SUMMARY OF THE INVENTION An embodiment of the invention is a method for auto matedly administering an audiometric test The method comprises the steps of controlling an audiometer to selec tively switch the audiometer output between test tones generated by the audiometer and sound signals generated from digital information first switching the audiometer output to sound signals when the step of controlling indi cates a beginning of a new test
25. g forks and other tone generating devices were employed In the early testing a test subject responded directly to a test administrator who recorded test results based on the administrator s subjective determinations The advent of the audiometer an electronic instrument that generates tones provided a degree of standardization in hearing testing because uniform tones and proper calibra tions are better achieved Even after the invention of the audiometer however hearing testing was far from standardized as testing varied in both procedures and determinations A standardized procedure still followed today was then developed for hearing testing That procedure is referred to as the Hughson Westlake procedure Other procedures are fol lowed in some instances but the Hughson Westlake proce dure is probably the most common In the Hughson Westlake procedure tones at a level audible to the test subject such as for example 30 dB are first presented to the subject The test subject responds that the tones are heard and then the level of the tones are reduced by 10 dB This is repeated with the test subject responding that the tones are heard followed by 10 dB reductions until the test subject s response or lack of response indicates that the tones are not heard When the 10 15 20 25 40 45 50 55 60 65 2 test subject so responds that the tones are not heard the tone level is raised 5 dB If th
26. h the multimedia audiometer 100 and the con ventional audiometer 2 share these similar basic elements the basic audiometer 200 is merely a subset of the entire multimedia audiometer 100 as is apparent in FIG 4 In addition to the elements of the basic audiometer 200 2 the multimedia audiometer 100 includes a computer 102 such as a personal computer another type of computer or some other processing and storage device The computer 102 may be equipped and connected with peripherals such as a keyboard 106 and a display monitor 104 as well other known input output communications printing and periph eral equipment In any event the computer 102 should have multimedia capabilities that is the computer 102 should be capable of producing sound waves and or visual images from representative digital information stored generated and or manipulated within or by the computer 102 The computer 102 may be conductively connected with the basic audiometer 200 through two interfaces a commu nications interface 108 and a multimedia input interface 110 The communications interface 108 may allow for serial parallel or other communications If communications are serial the communications interface 108 may connect the computer 102 with the RS232 port 8a shown in FIG 1 in standard manner as though the basic audiometer 200 is a peripheral to the computer 102 The multimedia input inter face 110 requires however that the conventional audiom
27. he sound signals after the 63 Continuation of application No 08 639 694 filed on Apr 29 1996 now Pat No 5 811 681 2 etre net A61B 5 00 step of first switching second switching the audiometer output to test tones after the step of outputting and output 52 US Cl incerto 600 559 ting test tones until the next step of first switching 58 Field of Search 600 559 14 Claims 8 Drawing Sheets 104 74 DISPLAY Eoo MULTIMEDIA IMPUT SERIAL COMMUNICATION ex AUDIOMETER HANDSWITCH 102 200 COMPUTER 106 KEYBOARD 52 US 6 416 482 B1 Sheet 1 of 8 Jul 9 2002 U S Patent LHV Ed HOIVnN3llV HOIO3I3S OINOHIO3T3 AON3no3H3 amp JOHLINOO a HOlvu3Nao Yad 3S Td JAVM3NIS SSVd ow HOLVU3N3O HOLVEANaS 9r V cy 7 ea 30vJH31NI 2 L 8l HOLVNNALLV kus epe Se eee eee a La bb 9r t over wove HOLIMSQNVH 3NOHduV3 E e V Q O 05 HOLIMSQNVH dNOHddV3 U S Patent Jul 9 2002 Sheet 2 of 8 US 6 416 482 B1 5 FLI 4 220VAC 70 U8 SPP gt gt gt gt PPP lt MPU 45 N 9 DATA LATCH Fig 2A PRIOR ART U S Patent
28. ignals in respect of digital data electrically connected with the processor a test tone generator electrically connected with the processor and a switch connected with the sound wave generator the test tone generator and the processor The switch is controlled by the processor to selectively cause either the sound wave generator or the test tone generator to output sound waves A further embodiment of the invention is an instrument that conducts a test protocol on a test subject The test protocol comprises an output by the instrument followed by an input to the instrument The test subject determines the input which input may be positive negative or null The instrument comprises an output generator an input detector for detecting the input a digital data storage for storing a digital data a multimedia converter the multimedia con verter converts the digital data to an analog signal and logic circuitry connected to the input detector the digital data storage the multimedia converter and the output generator for logically operating on the input reading the digital data delivering the digital data to the multimedia converter and controlling the output generator Yet another embodiment of the invention is a multimedia audiometer The multimedia audiometer comprises a basic audiometer a computer a multimedia input interface com municatingly connecting the computer and the basic audiometer and a communications interface communic
29. ious embodi ments of the present invention as particularly employed with the conventional audiometer 2 It is to be understood that the conventional audiometer 2 is detailed only for example purposes and all other alternative audiometer configurations as well as other instrumentation and con figurations thereof are also applications for the invention in accordance with the principles herein Conventional Audiometer The conventional audiometer 2 is generally comprised of three parts microprocessor circuitry 4 audio circuitry 6 and certain optional elements 8 In addition to those three parts the conventional audiometer 2 includes a power supply and related elements not shown in the functional block diagram One example of the conventional audiometer 2 is the RA250 Microprocessor Audiometer available from TREMETRICS Inc Austin Tex Of course as previously mentioned the conventional audiometer 2 illustrated is shown only for purposes of illustration and example Other audiometers and other types of medical and diagnostic instrumentation are also within the scope of the invention Microprocessor Circuitry The microprocessor circuitry 4 of the conventional audi ometer 2 may include a processing unit CPU 12 such as for example an Intel 8085 microprocessor or another microprocessor The CPU 12 serves to coordinate and con trol operations and functions of the conventional audiometer 2 The CPU 12 conductively connects with vario
30. ire error code list is as follows Error Multimedia Audiometer Code Indication Response AA Not Tested DD Deleted Frequency EE No Response Test Continues EF Test Incomplete 10 15 25 30 35 40 45 50 55 60 65 12 continued Error Multimedia Audiometer Code Indication Response EB 25 Presentations Test Continues No HTL 1 No Response Stops Test Repeat 1 KHz Instructions E2 1 KHz 25 Stops Test Repeat Presentations No Instructions HTL E3 1 KHz Retest Stops Test Repeat Error Instructions E4 Hand Switch Stops Test Holding Error Switch MSG ES Response No Tone Stops Test Response w window closed E6 Error For Second Stops Test Examiner Time Intervention E7 Max Failed Stops Test Examiner Frequencies gt 6 Intervention E8 Hardware Error Only seen at Turnon and After EPROM Diagnostic Check Error Codes That Do Not Stop Test EE Error Codes that Get Instructions and Resume Testing EB Same as E2 message Error Codes That Stop Test and Pop Up Message on PC for Operator Test Does Not Restart E3 E6 E7 In the case that a re test 328 is warranted because of an error or otherwise the operations 300 begin anew with the computer control 304 of the basic audiometer 200 over the communications interface 108 shown in FIGS 4 5 to trigger the relays 64a b The testing thereafter proceeds through the steps of selection and output 306 computer control 308 test tone generation 310 test subject
31. ities There are also many possible variations and alternatives in the configuration of the computer 102 and the basic audiometer 200 by providing the audiometer with additional memory processing wave sound generation and appropri ate software Alternatively the computer 102 could include test tone generation means and appropriate software pro gramming to perform the functions of the basic audiometer 200 Even further the multimedia audiometer 100 could be implemented by using a programmable digital tape player or compact disc CD player and allowing the basic audiometer 200 to select desired tracks to play Other alternatives may be possible it being understood that those skilled in the art will generally know and appreciate that the employment of computer or other control of instrumentation operations during test administration and the use of multimedia features for instruction messages and other herebefore required human administrative actions is possible with the incorpo ration of digital data according to the embodiments of the present invention from which are derived multimedia fea tures It is to be understood that multiple variations changes and modifications are possible in the aforementioned embodi ments of the invention Although illustrative embodiments of the invention have been shown and described a wide range of modification change and substitution is contem plated in the foregoing disclosure and in some instanc
32. le include the following SPECIAL FUNCTION 00 Initialization of audiometer 01 Enter date and time 02 Mode Pulsed Continuous 03 Enter Examiner ID 04 Invent runtable to test better ear first 05 Select Printer Format 06 Select or Delete 8K 07 Select Baud rate 08 Turn on or off audio feedback for key pushes 09 Accelerated listening check 0 Check calibration date 1 Call Ram Rom check 2 Calibration mode and program calibration eeprom 3 Printer text 4 Not used 5 Display routine for time and date no entry 6 Not used 7 Display selected audiogram 8 Print selected audiogram or audiograms 9 Display and or enter serial number 20 Not used Software protocols to accomplish the start up and initial ization of the basic audiometer 200 may be stored in the memory 14 16 of the basic audiometer 200 or elsewhere 10 15 20 25 30 40 45 50 55 60 65 10 Processing and control for the start up and initialization of the set up functions 302 are performed by the CPU 12 of the basic audiometer 200 Alternatively the basic audiometer 200 could be controlled by the computer 102 to perform the start up and initialization or start up and initialization could be controlled manually or in some other manner After the set up functions 302 including start up and initialization of the basic audiometer 200 are completed the basic audiometer 200 may be ready to begin administering a new audiometric test of a test subj
33. ly con nected with the means for outputting sound signals and the means for outputting test tone and means for controlling the means for switching the means for controlling being communicatingly connected with the means for switching 10 15 20 25 30 35 40 45 50 60 65 14 4 A multimedia audiometer comprising a multimedia computer a tone generator a switch connected with the computer and the tone generator wherein the switch selectively causes either the tone generator or the computer to output sound waves and the computer controls the switch 5 An instrument the instrument conducts a test protocol on a test subject the test protocol comprises an output by the instrument followed by an input to the instrument the test subject determines the input the input may be positive negative or null comprising an output generator an input detector for detecting the input a digital data storage for storing a digital data a multimedia converter the multimedia converter con verts the digital data to an analog signal and logic circuitry connected to the input detector the digital data storage the multimedia converter and the output generator for logically operating on the input reading the digital data delivering the digital data to the mul timedia converter and controlling the output generator 6 The instrument of claim 5 wherein the output generator comprises an analog tes
34. ng Other medical and diagnostic instrumentations include a spirometer for measuring lung capacity vision testing equipment blood alcohol testing equipment and occupational health industry maintenance testing equipment such as blood pressure EKG and other wellness testing equipment Generally these and other prior testing instrumentations require one or more individuals to administer the test by operating the equipment and giving instructions to the test subject The trend in testing however appears to be toward automation Through automation reduced numbers of test administrators may be required and increased accuracy of testing with lack of deviation caused by human adminis trator error may be possible Although certain limited auto mation has previously been possible that automation has been directed primarily to the automated compilation organization and reporting of data in desirable formats Processing units such as for example personal computers have previously been employed to achieve the automation of the compilation organization and reporting functions Little automation if any has previously been achieved however in connection with the actual administration of the test Administration of such tests has typically been performed almost wholly by one or more human test administrators Hearing testing has for several decades been performed utilizing an instrument called an audiometer Prior to the audiometer tunin
35. putting between the test tone and the analog signal processing the digital data and controlling the steps of outputting generating the test tone storing generating the analog sound and switch ing US 6 416 482 B1 15 10 A multimedia audiometer comprising a basic audiometer a computer wherein the computer comprises a sound wave generator for converting a digital information to analog signals with respect of the digital information a multimedia input interface communicatingly connecting the computer and the basic audiometer and a communications interface communicatingly connecting the computer and the basic audiometer 11 A multimedia audiometer comprising a basic audiometer an output speaker connected to the basic audiometer a computer a multimedia input interface communicatingly connecting the computer and the basic audiometer a communications interface communicatingly connecting the computer and the basic audiometer and a switch connected to the multimedia input interface and the basic audiometer in a first position and the output speaker in a second position for switching between a first signal communicated over the multimedia input interface and a second signal generated by the basic audiometer as an output for the output speaker 10 15 20 16 12 A multimedia audiometer comprising a basic audiometer a computer wherein the computer and the basic audiom eter communicate over the
36. several ways The program mable registers 26 may serve as ports that connect with an oscillator also frequency generator 30 The oscillator 30 may provide timing for a sine wave generator 32 that produces a digitally synthesized sine wave from which audible test tones are derived Because the sine wave gen erator 32 produces a digitally synthesized wave the wave may be smoothed by a low pass filter 34 The low pass filter 34 may connectively interface with the parallel interface 24 of the microprocessor circuitry 4 Other elements of the audio circuitry 6 such as a frequency selector 36 an electronic attenuator 38 a pulse control 40 a relay control attenuator 42 and a handswitch jack 44 may conductively connect with the parallel interface 24 to com plete the interface of the audio circuitry 6 with the micro processor circuitry 4 of the conventional audiometer Pur suant to this interface arrangement the audio circuitry 6 and the microprocessor circuitry 4 may communicate signals for control and other purposes In addition to the connection of the low pass filter 34 with the parallel interface 24 the low pass filter 34 may conduc tively connect with frequency compensation circuitry such as for example a frequency selector 36 that together with the control provided through the parallel interface 24 helps compensate for attenuation Other elements such as the electronic attenuator 38 which connects with the frequency selec
37. t 5 of 8 US 6 416 482 B1 R4 1C2 2M 100PF MULTIMEDIA IMPUT J SERIAL COMMUNICATION COMPUTER US 6 416 482 B1 Sheet 6 of 8 Jul 9 2002 U S Patent Mowe HOLIMSONVH os HO LIMSONVH 2INOHI23T3 e I TOUINOO HOLWHANAD L AS id YHOLVANALLY lOHLNOO AV T3H Mowe 3NOHdHV3 Q 0 0 3NOHduV3 YHOLVNNALLV x YOLOATAS AON3n038H JAVM3NIS HOLVH3N39 AON3n039Ud ualadridW OIN V G 5n vC uan JOVIUSINI SSVd MOT E H31ndNOO k gt QHYOBA3M vol 901 201 910 0c QHVOSA3M cl 81 U S Patent Jul 9 2002 Sheet 7 of 8 US 6 416 482 B1 ee 121 R4 LC2 2M 100PF 120a 120 Fig 8 U S Patent Jul 9 2002 Sheet 8 of 8 US 6 416 482 B1 300 START UP AND INITIALIZATION OF COMPUTER AND BASIC AUDIOMETER y COMPUTER CONTROLS BASIC AUDIOMETER TO TRIGGER RELAYS TO CLOSE SWITCHES RE TEST CONNECTING SOUND PORT AND TO OPEN SWITCHES CONNECTING TONES CONTROL SIGNALS PASSED OVER SERIAL INTERFACE 302 304 306 COMPUTER SELECTS AND OUTPUTS SOUND FILE S REPRESENTING INSTRUCTIONS ERROR MESSAGES OUTPUT OVER MULTIMEDIA INTERFACE 308 COMPUTER CONTROLS BASIC AUDIOMETER TO TRIGGER RELAYSTO OPEN SWITCHES CONNECTING SOUND PORT AND TO CLOSE SWITCHES CONNECTING TONES CONTROL SIGNALS PASSED OVER SERIAL INTERFACE 310 328 BASIC AUDIOMETER GENERATES
38. t tone generator and a sound wave generator for producing sound waves representative of the analog signal 7 The instrument of claim 6 wherein the output generator further comprises a switch for switching the output genera tor between the analog test tone generator and the sound wave generator 8 A diagnostic instrument comprising means for outputting an audible sound means for generating a test tone means for storing a digital data means for generating an analog signal derived from the digital data means for switching an output of the means for outputting between the test tone and the analog signal the means for switching being electrically connected to the means for generating a test tone and the means for generating an analog signal means for processing means for inputting the means for inputting connects the means for processing to the means for outputting and means for communicating the means for communicating connects the means for processing to the means for outputting the means for generating the test tone the means for storing the digital data the means for gen erating the analog signal the means for switching and the means for inputting 9 A method of performing a diagnostic test protocol comprising the steps of outputting an audible sound generating a test tone storing a digital data generating an analog sound derived from the digital data switching the audible sound from the step of out
39. tor 36 also provide compensation for attenuation The sine wave generator 32 feeds the pulse control 40 which together with input to the pulse control 40 from the elec tronic attenuator 38 delivers signals representative of desired test tones to a power amplifier 46 The power amplifier 46 feeds the relay control attenuator 42 for left and right earphone signals The relay control attenuator 42 is conductively connected with an earphone jack 48 In order to allow a test subject to interface with the audio circuitry 6 earphone speakers 50 and a handswitch 52 may be provided The earphone speakers 50 may plug into the earphone jack 48 The test subject wearing the earphone speakers 50 will then receive test tones generated by the conventional audiometer 2 The handswitch 52 may plug into the handswitch jack 44 The handswitch 52 provides means for the test subject to interface with the conventional audiometer 2 in order to signal to the conventional audiom eter 2 that the test subject either does or does not correctly receive test tones through the earphone speakers 50 Options In addition to the basic elements just described the conventional audiometer 2 may include certain optional 10 15 20 25 30 35 40 45 50 55 60 65 6 elements 8 Various optional elements 8 are possible depending upon desired operations and functions Two com mon optional elements 8 of the conventional audiometer 2 have been an RS23
40. tually any type of information which is subject to derivation from digital data Although sound is described here as being derived from digital data those skilled in the art will know and appreciate that digital data may be manipulated and processed in a multitude of ways to derive other types of information for example visual graph ics and images and others After the computer has selected and output 306 the desired sound signals to the basic audiometer 200 and signals have been delivered to the test subject as sound waves through the earphone speakers 50 the computer 102 again may control 308 the basic audiometer 200 The control 308 at this instant may trigger the relay 64a to close the switches 66a and the relays 66b shown in FIG 2 to open the switches 66b respectively The control 308 then causes the basic audiometer 200 to generate 310 a series of test tones such as for example tones in accordance with the Hughson Westlake procedure or another testing protocol When the switches 66a are closed and the switches 66b are opened because of the control 308 the test tones generated 310 by the audio circuitry 6 of the basic audiom eter 200 are delivered through the earphone jack 48 to the earphone speakers 50 According to the particular testing protocol the test subject may respond to the test tones by input 312 via the handswitch 52 connected to the basic audiometer 200 The basic audiometer 200 in cooperation with the computer 1
41. us memory such as for example erasable programmable read only memory EPROM 14 and random access memory RAM 16 The memory 14 16 may serve to store a software protocol which controls the CPU 12 to cause the conven tional audiometer 2 to provide audiometric functions The memory 14 16 may also serve to maintain certain variables US 6 416 482 B1 5 to achieve desired operations and calibration of the conven tional audiometer 2 or simply to provide storage for values made available to and from the CPU 12 In addition to the memory 14 16 the CPU 12 conduc tively connects with various input and output ports and peripherals Input and output ports may include a serial I O port 22 and a parallel interface 24 The serial I O port 22 may provide connections for certain optional elements 8 as hereinafter discussed The parallel interface 24 may connect with an input device for example a keyboard 20 The parallel interface 24 may also connect with the audio cir cuitry 6 as later explained Another input device such as a display 18 for example may connect with the memory 14 16 CPU 12 and other features of the microprocessor circuitry 4 Such other features of the microprocessor cir cuitry 4 may include for example certain programmable registers 26 and other elements Audio Circuitry Now discussing the audio circuitry 6 of the conventional audiometer 2 the audio circuitry 6 interfaces with the microprocessor circuitry 4 in
42. y 18 The basic audi ometer 200 is now ready for operation If a processing error by the CPU 12 is discovered during the turn on an appro priate message is displayed The following example illustrates an initialization proce dure for the basic audiometer 200 Keys of the keyboard 20 are indicated by and messages in quotes To begin press US 6 416 482 B1 KEYBOARD DISPLAY SPECIAL SPC00 ENTER MM DD YY Now enter today s date For example KEYBOARD DISPLAY COMMENT 04 30 96 OM DD YY The message mode pulsed then appears on the display 18 Press NO to switch to continuous mode Continuous Mode will be displayed Press ENTER when the desired code is displayed The display should now read 1 KL AA AUTO and then displays PRESS NEW Other parameters which may be selected include the test other ear first and delete 8000 Hz To do this press KEYBOARD DISPLAY COMMENT SPECIAL SPC 04 04 SPC 04 ENTER LEFT EAR FIRST NO RIGHT EAR FIRST ENTER 1KR AA AUTO Now testing right ear first SPECIAL SPC 06 06 SPC 06 ENTER 8KR SEL AUTO NO 8KR DEL AUTO ENTER 1KR AA AUTO 8 Khz is deleted The basic audiometer 200 is now initialized Any or all of the above mentioned parameters can be changed at any time by entering a desired special routine Various Special codes that may be possible with the basic audiometer 200 of the multimedia audiometer 100 may for examp
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