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GSi AUDIOSTAR PRO User Manual

Clinical audiometer
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GSI AUDIOSTAR PRO
™

USER MANUAL

Part Number 2012-0100 Rev. A
Setting The Clinical Standard
www.grason-stadler.com
Grason-Stadler, 7625 Golden Triangle Drive, Suite F, Eden Prairie MN 55344
800-700-2282 • 952-278-4402 • fax 952-278-4401 • e-mail info@grason-stadler.com

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  • Page 1: User Manual

    GSI AUDIOSTAR PRO ™ USER MANUAL Part Number 2012-0100 Rev. A Setting The Clinical Standard www.grason-stadler.com Grason-Stadler, 7625 Golden Triangle Drive, Suite F, Eden Prairie MN 55344 800-700-2282 • 952-278-4402 • fax 952-278-4401 • e-mail info@grason-stadler.com...
  • Page 2 Blank Page. 2012-0100 Rev. A...
  • Page 3 GSI AudioStar Pro Clinical Audiometer Title: GSI AudioStar Pro™ Clinical Audiometer User Manual Copyright © 2012 Grason-Stadler. All rights reserved. No part of this publication may be reproduced or transmitted in any form or by any means without the prior written permission of Grason-Stadler.

  • Page 4: Table Of Contents

    Table of Contents Intended Use ..............................8 Warranty ..............................8 Audiometric Standards ..........................9 Warnings, Cautions, and Errors ........................10 Status/Error Messages ..........................11 Customer Responsibility ......................... 11 Safety Precautions ............................13 Cautions - General ........................... 14 Warning - Connecting Additional Equipment ..................14 Warning - Electric Shock Hazards ......................
  • Page 5 GSI AudioStar Pro Clinical Audiometer Monitor ..............................32 Bottom Panel Label ..........................33 Front Panel Controls ........................... 34 Power ............................... 34 Stimulus Intensity Level(s) ........................34 Talk Forward ............................35 Left & Right VRA ........................... 35 Interlock ..............................35 Tracking ..............................35 Status / Audiogram Button ........................
  • Page 6 High Hz Tab ............................62 Speech Tab .............................. 63 Norm Values Tab ............................ 63 Chapter 7: Integration ..........................64 GSI Instrument Services .......................... 64 Description .............................. 64 Operation ..............................64 Public Interface (Direct) .......................... 64 Data Port (Direct) ............................ 64 GSI Suite ..............................
  • Page 7 GSI AudioStar Pro Clinical Audiometer Periodic Checks ............................66 Earphone and Bone Vibrator Cords ......................66 Hum and Noise ............................66 Distortion and Frequency Shift ....................... 66 Speech Level Check ..........................67 Internal Controls Check........................... 67 Bone Vibrator Check ..........................67 Masking Level Check ..........................
  • Page 8 Recommended Separation Distances between Portable and Mobile RF Communications Equipment and the GSI AudioStar Pro ..........................90 Guidance and Manufacturer’s Declaration - Electromagnetic Immunity ..........91 Guidance and Manufacturer’s Declaration - Electromagnetic Immunity ..........92 Appendix 3: Reference Materials ......................93...

  • Page 9: Intended Use

    GSI AudioStar Pro Clinical Audiometer Intended Use The AudioStar Pro is intended to be used for the identification and etiology of hearing loss in patients of any age. It is intended to be used by an audiologist, ENT, hearing healthcare professional, or trained technician in a hospital, clinic, healthcare facility or other suitable quiet environment as defined in ANSI S3.1 or...

  • Page 10: Audiometric Standards

    Audiometric Standards The AudioStar Pro is designed to meet or exceed the following standards: Audiometer Standard Requirements - Type 1 1. ANSI S3.6 (2010) Specification for Audiometers (Type 1) 2. IEC 60645-1 Electroacoustics - Audiological Equipment - Pure-Tone Audiometers Type 1 3.

  • Page 11: Warnings, Cautions, And Errors

    GSI AudioStar Pro Clinical Audiometer Warnings, Cautions, and Errors The GSI AudioStar Pro Clinical Audiometer is designed to be used with a hospital grade outlet. Injury to personnel or damage to equipment can result when a three-prong to two-prong adaptor is connected between the GSI AudioStar Pro power plug and an AC outlet or extension cord.

  • Page 12: Status/Error Messages

    The CAUTION label identifies conditions or practices that could result in damage to the equipment. NOTE: Notes help identify areas of possible confusion and avoid potential problems during system operation. Status/Error Messages Please try another selection: Indicates that an incorrect selection, such as incompatible transducers, routing, or there is no calibration data stored for the selected transducers.
  • Page 13 Do NOT use the AudioStar Pro in a highly oxygen-enriched environment, such as a hyperbaric chamber, oxygen tent, etc. Periodically, have a service technician perform electrical safety checks on the unit in order to maintain continued compliance to IEC and UL 60601-1.

  • Page 14: Safety Precautions

    ANY EQUIPMENT CONNECTED TO THE GSI INSTRUMENT AND USED IN THE PATIENT VICINITY MUST BE POWERED BY AN ISOLATED POWER SOURCE TO MAINTAIN THE ELECTRICAL SAFETY OF THE OVERALL SYSTEM.

  • Page 15: Cautions - General

    Always turn OFF system power before connecting or disconnecting system components to help guard against personal injury. Warning - Electric Shock Hazards Do not open the case of the GSI Instrument. Do not remove any GSI instrument covers. Refer servicing to qualified personnel. Warning - Electric Grounding This device uses a three wire power cord with a hospital grade plug (for international applications, IEC 60601-1 approved plug).

  • Page 16: Warning - Line Voltage Brownout And Interruptions

    Proper use of this device depends on careful reading of all instructions and labels. Follow all safety standards set by each place of employment. Shutdown Procedure To turn off the GSI AudioStar Pro, use the power switch on the right side of the device. Recycling / Disposal...

  • Page 17: Regulatory Symbols

    GSI AudioStar Pro Clinical Audiometer Regulatory Symbols Symbol IEC Pub. Description 980 & 60601-1 Conforms to European Medical Device Directive 93/94/EEC. Symbol for "USE BY." Symbol for "BATCH CODE." Symbol for "SERIAL NUMBER." 980 & 60601-1 Symbol for "STERILE." Return to Authorized Representative, Special disposal 980 &...
  • Page 18 Symbol IEC Pub. Description 60601-1 On/Off - Next to power mains. Keep Dry. 60601-1 Transport and storage temperature range. 60601-1 60601-1 Transport and storage humidity. This side up. 60601-1 Monitor. 60601-1 60601-1 Patient response switch. Follow Instructions for Use. ISO 7010-M002 2012-0100 Rev.

  • Page 19: Specifications

    GSI AudioStar Pro Clinical Audiometer Specifications Dimensions and W x D x H: 20.1 inches x 14.6 inches x 13.2 inches (LCD raised) Weight 51.0 cm x 37.0 cm x 33.5 cm Height with LCD lowered: 5.5 inches 14.0 cm...
  • Page 20 Bone Conduction: Speech - Channel 1 -10 dB HL to 55 dB HL (mastoid) and Channel 2 -10 dB HL to 35 dB HL (forehead) Sound Field:* -10 dB HL to 90 dB HL (basic speakers) Paired Inserts:* -10 dB HL to 95 dB HL Masking Intensity Range Speech Noise: Air Conduction...

  • Page 21: Audiometric Symbols

    GSI AudioStar Pro Clinical Audiometer Quality System Manufactured, designed, developed and marketed under ISO 13485 certified quality systems Compliance/Regulatory Designed, tested and manufactured to meet the following domestic (USA), Canadian, European and Standards International Standards: ANSI S3.6, IEC 60645-1, IEC 60645-2, ISO 389...

  • Page 22: Frequency Limits

    1. The maximum hearing level for speech with the Linear speech filter in place is 100 dB. NOTE: The hearing levels listed in this table are maximum levels. These levels are achievable only if ANSI, ISO or GSI reference threshold levels, and not customized calibration values, are used. At no time will the hearing level limit exceed 120 dB HL.

  • Page 23: Elimination Of Ambient Noise

    8000 43.5 Elimination of Ambient Noise The GSI AudioStar Pro can be installed in a single room environment or as part of a two room suite. Excessive noise in the test environment, such as that produced by conversation, office equipment, or printers, reduces test validity because it tends to mask the test signals.
  • Page 24 USB Port The AudioStar Pro is equipped with four (4) USB ports. It is possible to connect external devices such as mouse, keyboard, or external printer to be used with the audiometer.
  • Page 25 GSI AudioStar Pro Clinical Audiometer Printing Press the PRINT pushbutton on the front panel of the GSI AudioStar Pro to send the stored audiometric data to the printer. Instrument Operation While Printing The GSI AudioStar Pro remains operational while printing with the following exceptions: pressing the Data Erase, Store or Data Transfer pushbuttons while printing will result in the error message Please try another selection.
  • Page 26 2012-0100 Rev. A...

  • Page 27: Accessories

    GSI AudioStar Pro Clinical Audiometer Accessories* Part Numbers Product Descriptions Part Numbers AudioStar Pro™ Clinical Two-Channel Audiometer - Configuration (with internal display) 2012-97xx-0 Subject Response Hand switch 7874-0156 Headset, Operator/Monitor 2012-9623 Headphones, Assistant (Aux Intercom) 2012-9624 Extension cable - Assistant headphones, 3.5 meters...

  • Page 28: Country Kits

    Country Kits GSI Country Kits include a power cord specific to a region of the world and a user manual in the language for the specific country. Part Number Country Description 2012-9400 United States Power Cord, English 2012-9401 United States Power Cord, Spanish...

  • Page 29: Chapter 1: Introduction

    User login and password controls provide security for patient data in compliance with HIPAA. Complete audiometric results can be transferred to software such as GSI Suite and NOAH, or integrated with your facility’s EMR/EHR system.

  • Page 30: Chapter 2: Installation

    Notify the carrier if any damage is observed. Unpacking Carefully remove the GSI AudioStar Pro from its shipping container. If the instrument appears to have suffered any damage, notify the carrier immediately so that a proper claim can be made. Be certain to save all packing material so that the claim adjuster can inspect it as well.

  • Page 31: Connectors, Controls And Indicators

    GSI AudioStar Pro Clinical Audiometer Connectors, Controls and Indicators Rear Panel The connectors on the rear panel of the GSI AudioStar Pro are shown in the following diagram. The label and jacks are visible by turning the instrument around on a flat, stable surface.

  • Page 32: Right Side Panel

    Outputs Left (blue) and Right (red) 3.5 mm stereo jack to activate a left or right R12 VRA Connection Output VRA system (contact a GSI service representative for details) R13 Left and Right High 6.35 mm stereo jack Frequency Headset...

  • Page 33: Left Side Panel

    Monitor The AudioStar Pro comes standard with an internal LCD display monitor. It is possible to order the AudioStar Pro without the internal monitor and connect it to an external HDMI compatible monitor. NOTE: Recommended specifications for external monitor are as follows: HDMI high definition monitor, 21.5 inch screen that supports 800 x 600 resolution in...

  • Page 34: Bottom Panel Label

    Manufacture Date (year will be inserted below). China RoHS symbol for products with a 50 year life cycle. B Patient Applied Part according to IEC 60601-1. Serial Number and GSI Part Number. Return to authorized representative, special disposal required. Manufacturer.

  • Page 35: Front Panel Controls

    GSI AudioStar Pro Clinical Audiometer Front Panel Controls The controls on the front panel of the GSI AudioStar Pro are shown below. Power The green LED, located in the upper right portion of the front panel, is illuminated when mains power is supplied to the GSI AudioStar Pro. This indicates that the power switch is in the on position.

  • Page 36: Talk Forward

    Mic/Monitor headset or optional gooseneck microphone. Selection of the Talk Forward button interrupts the stimulus that is being presented. The GSI AudioStar Pro resumes the test status when the pushbutton is released. The light pipe around the Talk Forward button will be illuminated when enabled.

  • Page 37: Printing

    GSI AudioStar Pro Clinical Audiometer Printing If the appropriate printer is connected to the AudioStar Pro and the printer has been configured properly using the Configuration Application Software, the current stored test information is sent directly to the printer when the Print pushbutton is pressed.

  • Page 38: Transducer Output Selector

    Refer to the following table for the stimuli compatibilities listing: Valid Stimuli Combinations Channel 1 Stimulus White Tone Ext. A Ext. B S Noise Noise Noise Tone Valid Valid Valid Valid Valid Invalid Valid Valid Valid Valid Valid Invalid Valid Valid Ext.

  • Page 39: Routing Output Selector

    Attenuators (HL Controls) Channel 1 and Channel 2 The GSI AudioStar Pro contains two independent HL rotary controls for test signal and masking intensity level control with a range of -10 dB HL to 120 dB. HL Maximum dB HL values apply to the mid-frequencies with earphones only.

  • Page 40: Navigation Controls

    Navigation Controls The four navigation buttons and the middle select button may be used to make selections from the on-screen menus as well as navigate through the internal .Wav files for speech testing. Scorer / Timer The Correct, Clear and Incorrect pushbuttons are used for scoring results in Speech and SISI tests.

  • Page 41: Test Type Buttons

    Configure - From this screen, it is possible to view the instrument information such as serial number, software version and the custom logo. This button displays setup options to update the AudioStar Pro software, set the date and time and configure bone conduction symbol settings.

  • Page 42: Chapter 3: Function Specific Display

    Chapter 3: Function Specific Display A Liquid Crystal Display (LCD) is hinged to the GSI AudioStar Pro and is used to display all of the testing information from the instrument. When the LCD is in the lowered position, easy access to the rear connector panel is provided.

  • Page 43: Tone Test Type Display

    GSI AudioStar Pro Clinical Audiometer Tone Test Type Display Top Title Bar  On the left side of the title bar, the patient name, if entered, will be displayed.  In the center of the upper title bar, the test type (Pure Tone) will be displayed.
  • Page 44 Black crosshairs on the graph indicate position of the attenuator and oscillator. The appropriate symbols will be displayed on the audiogram after either of the Store buttons has been pressed. The effective masking levels for air conduction and bone conduction will be displayed below the audiogram graphs. Blue Navigation Menu Signal ...
  • Page 45 GSI AudioStar Pro Clinical Audiometer Pure Tone Audiogram a. Frequency, in Hz, selected for Channel 1 and Channel 2. b. Patient Response indicator. c. Effective Masking Level. d. Current output in dB HL for Channel 1 and Channel 2. e. The stimulus, transducer and routing currently selected for each Channel f.
  • Page 46 The following figure shows the Tone Status screen. Pure Tone Status a. The output, in dB HL, for Channel 1 and Channel 2. b. The stimulus, transducer and routing currently selected for each channel. c. Frequency, in Hz, Patient Response indicator. d.

  • Page 47: High Hz Test Type Display

    GSI AudioStar Pro Clinical Audiometer High Hz Test Type Display The display for the High Hz and the Tone tests are identical except for the “range” option on the navigation menu. The Sennheiser HDA 200 Headphones may be calibrated from 125 Hz to 20 kHz.

  • Page 48: Speech Test Type Display

    Full Frequency Audiogram Speech Test Type Display The screen displays the following: Top Title Bar  On the left side of the title bar, the patient name, if entered, will be displayed.  In the center of the title bar, the test type (Speech – SRT, SDT, WRS, SRS, MCL, or UCL) will be displayed.

  • Page 49: Blue Navigation Menu

    GSI AudioStar Pro Clinical Audiometer Scoring Window This window displays the speech scores in a percentage value. The scores are populated using the Correct/Incorrect buttons on the front panel of the instrument. NOTE: When using internal .Wav files, the Correct, Incorrect and Clear buttons are inactive while the stimulus is being presented.

  • Page 50: Speech Status Screen

    Stenger  When a Speech Stenger is performed, a “+” will indicate a positive result.  When a Speech Stenger is performed, a “-” will indicate a negative result. Speech Status Screen This screen displays a numeric representation of the Speech Test Results. When Store is pressed, the following information appears in the Speech Test Results Table: a.
  • Page 51 Word recognition scores will be plotted on the Speech Audiogram based on the intensity at which the test was performed and the score that was achieved. As additional WRS are plotted, the AudioStar Pro will determine PIPB (Performance Intensity Function for Phonetically Balanced Words) function.

  • Page 52: Chapter 4: Operation

    Inspect all cords for fraying and damage. If there is any damage to any cord, do not use the AudioStar Pro. If speech testing with recorded voice from an external source is to be performed, check that the CD or digital music player device is connected and operating properly.

  • Page 53: Typical Evaluations

    NOTE: If you select a different transducer or stimulus or ear and leave the tone test type, when you return to tone, the AudioStar Pro will default to the last settings that were selected.

  • Page 54: More Test Type Button

    NOTE: If you select a different transducer or stimulus or ear and leave the High Hz test type, when you return, the AudioStar Pro will default to the last settings that were selected. ...

  • Page 55: Chapter 5: Test Procedures

    GSI AudioStar Pro Clinical Audiometer Chapter 5: Test Procedures Routine Test Procedures The following procedures are in compliance with the current ANSI and ISO recommendations for Manual Pure Tone Threshold Audiometry. Patient Instructions Preparing the subject for test: 1. Put the subject at ease.

  • Page 56: Spondaic Speech Testing, Speech Reception Threshold (Srt)

     Repeat the sections on Patient Familiarization and Threshold Determination for each tone setting in the following order: 1,000 Hz, 2,000 Hz, 4,000 Hz, 8,000 Hz. Retest 1,000 Hz followed by 500 Hz and 250 Hz. If there is a difference of 20 dB or greater between octaves, test the inter-octave frequencies, i.e.

  • Page 57: Special Test Procedures

    GSI AudioStar Pro Clinical Audiometer Special Test Procedures The AudioStar Pro may be configured to perform many audiologic evaluations for further diagnosis, to rule out the presence of malingering and for research purposes. This section describes special test procedures that have been optimized for use with the GSI AudioStar Pro audiometer.

  • Page 58: Quicksin

    QuickSIN The primary complaint of hearing-impaired persons is difficulty in background noise. The measurement of SNR loss (signal-to-noise ratio loss) is important because speech understanding in noise cannot be reliably predicted from the pure tone audiogram (Killion & Niquette, 2000). For detailed information on the QuickSIN, please see Appendix 1.

  • Page 59: Sisi (Short Increment Sensitivity Index) Test

    GSI AudioStar Pro Clinical Audiometer SISI (Short Increment Sensitivity Index) Test The SISI test is used to detect small intensity changes in a steady-state signal in patients with disorders of the cochlea. The SISI tests a patient’s ability to detect 1 dB change of intensity in a pure tone stimulus at 20 dB SL.

  • Page 60: Tone Decay Test

    Presentation Level  If the hearing loss is 60 dB or less, start the TEN noise level at 70 dB.  If the hearing loss is 70 dB or greater, start the TEN level 10 dB higher than the threshold. ...

  • Page 61: Additional Special Tests

    Additional Special Tests The AudioStar Pro may be configured to perform many other audiologic evaluations for further diagnosis, to rule out the presence of malingering and for research purposes. More information on several of the tests may be found on the quick guide, Special Tests for the AudioStar Pro.

  • Page 62: Chapter 6: Configuration Application Software

    Default: Loads all factory default settings into the configuration application. Changes will not be reflected on the AudioStar Pro until they are downloaded to the unit. Load: Allows the operator to select a specific protocol from a list of saved configurations.

  • Page 63: Instrument

    Word Lists Tab When loaded from the AudioStar Pro, this window lists the existing word lists. External CD names may also be added. Log Tab In the event of a repeatable error, the log window allows you to upload a file from the AudioStar Pro to the computer.

  • Page 64: Speech Tab

    QuickSIN and filter settings for the free-field speakers. Norm Values Tab The GSI factory does not include sample norm values to be used on the Speech Audiogram screen. Each facility should enter their own values, if desired. If Display on the AudioStar Pro box is checked, the normative curves will appear on the Speech Audiogram screen based on the transducer being used.

  • Page 65: Chapter 7: Integration

    Description The GSI Instrument Services allows electronic transmission of test parameter information from the AudioStar Pro to an external computer with a single push of the Data Transfer button. See the GSI Instrument Services user manual for detail on how to utilize its functionality.

  • Page 66: Noah 4

    Suite and OtoAccess increase the efficiency of the contemporary audiology practice. NOAH 4 GSI Suite may be installed in NOAH 4 as a measurement module providing seamless integration between the audiometric evaluation and the hearing instrument fitting. NOAH 4 may be installed as a standalone software or on a network.

  • Page 67: Chapter 8: Routine Maintenance

    With extended use, all transducer cords tend to fray internally at the connectors. To evaluate the cord status, turn on the GSI AudioStar Pro. Set the HL to a comfortably audible level. Place the transducer on your head. Activate both Interrupt buttons.

  • Page 68: Speech Level Check

    earphones are at fault and should be replaced. In any case, the audiometer should be scheduled for immediate maintenance. Speech Level Check To check the speech level with recorded speech, select the Speech test type button. Place the earphones on a person with normal hearing and present a word list at 40 dB.

  • Page 69: Cleaning And Disinfecting Agents

    GSI AudioStar Pro Clinical Audiometer Cleaning and Disinfecting Agents According to the recommendations from the CDC, audiometric equipment is considered to be non-critical medical equipment and typically requires cleansing followed by low to intermediate level disinfecting, depending on the nature of the contamination.

  • Page 70: Calibration Reference Levels

    Calibration Reference Levels It is recommended that each GSI AudioStar Pro receive a thorough calibration certification once a year by an authorized GSI Representative using the appropriate calibration instrumentation. If periodic checks are also desired, the tables in this section provide the SPL values per frequency for each transducer. If the measured values are not within ±...
  • Page 71 GSI AudioStar Pro Clinical Audiometer NOTE: For narrow band noise, the level control is calibrated in dB of effective masking. The SPL in each one-third octave band centered at each frequency is calibrated to a level 3 dB above the standard reference level for this frequency.
  • Page 72 Bone Vibrator (B71) Calibration Values for Non-occluded Test Ear Mastoid Placement Coupler / 1000 1500 2000 3000 4000 6000 8000 Speech Frequency 67.0 58.0 48.5 42.5 36.5 31.0 30.0 35.5 40.0 40.0 55.0 dB re: IEC 60318-6 NOTES: These values were obtained with 40 dB effective masking by air conduction to the non-test ear.
  • Page 73 GSI AudioStar Pro Clinical Audiometer Reference Levels for Pure Tones with Sennheiser HDA 200 SPL Values with the Sennheiser HDA 200 Earphones for 0 dB HL Setting Coupler / 1000 1500 2000 3000 4000 6000 Frequency 30.5 18.0 11.0 17.0...

  • Page 74: Appendix 1: Quicksin™ User Manual

    Appendix 1: QuickSIN™ User Manual Provided by Etymōtic Research © , Inc. 61 Martin Lane Elk Grove Village, IL 60007 www.etymotic.com Quick Start  Present the test with earphones or in a sound field, with the attenuator dial set to 70 dB HL. For subjects with PTA hearing losses greater than 45 dB HL, set the attenuator dial to a level that is “loud but OK.”...

  • Page 75: Quicksin Methodology

    GSI AudioStar Pro Clinical Audiometer  Demonstrate that hearing aids with directional microphones improve speech intelligibility in noise  Provide a large number of equivalent test lists for use in clinical and research work  Provide information useful in counseling patients regarding realistic...

  • Page 76: How To Use The Quicksin

    Setup Select QuickSIN from the More Test Type button on the GSI AudioStar Pro™. The QuickSIN test may be presented via loudspeaker, insert earphones or TDH earphones. When presenting the QuickSIN test via loudspeaker, present it through one loudspeaker only, with the subject seated facing the loudspeaker (0º...

  • Page 77: Practice Lists

    GSI AudioStar Pro Clinical Audiometer Practice Lists Tracks 21-23 contain Practice Lists A-C. They can be used to familiarize the patient with the test protocol or to determine the “loud but OK” presentation level for persons with hearing loss of 50 dB HL and greater. These lists are NOT equivalent to lists 1-12 or list pairs, and do not reliably predict SNR Loss.

  • Page 78: What Is Snr Loss

    What is SNR Loss? We are interested in the patient’s performance in noise compared to normal- hearing persons’ performance in noise. We consider this difference in performance the SNR Loss. Similar to the definition of pure tone hearing loss, SNR Loss is defined as the dB increase in signal-to-noise ratio required by a hearing-impaired person to understand speech in noise, compared to someone with normal hearing.

  • Page 79: Where Does The Number 25.5 Come From

    GSI AudioStar Pro Clinical Audiometer NOTE: For greater accuracy, two or more lists should be averaged (see page 88-89). Where Does the Number 25.5 Come From? First we need to explain where the number 27.5 comes from. Following the Tillman- Olsen (1973) recommended method for obtaining spondee thresholds, we have a simple method for estimating SNR-50 using nothing more than the total number of words correct.

  • Page 80: Separated Speech And Noise Channels

    Data on ski-slope hearing loss from Skinner (1980), Rankovic (1991), and Turner and Cummings (1999) indicate that some patients do worse with the extended high frequency emphasis prescribed by popular formulae than if the emphasis is restricted to regions of better hearing. Other patients with similar audiograms seem to benefit from the extended high-frequency amplification.
  • Page 81 GSI AudioStar Pro Clinical Audiometer to Directional, to verify that the directional microphones are working and providing directivity (rejection of sound from the sides and rear). Procedure If the loudspeakers are located at +45º and -45º, test each ear separately. Position the patient in the sound booth so that speech is presented from in front at 45º...

  • Page 82: Test Development

    If the loudspeakers are located at 0º and 180º, you may test each ear separately or both ears together. Position the patient in the sound booth so that speech is presented from in front at 0º and babble from behind at 180º. See Figure 4. Since the babble noise on Tracks 24-35 is at a constant level, two types of demonstrations are possible: 1.
  • Page 83 GSI AudioStar Pro Clinical Audiometer thus a more valid representation of real speech (Villchur, 1982). In the real world, the speech dynamic range is increased by the stress given to some words and syllables vs. the drop in level given to others. The effects of co-articulation are not well represented on monosyllabic word lists.

  • Page 84: Quicksin Search For Sentence Equivalence

    Background Noise The choice of background noise is an important component of any test. The purpose of the SIN test was to obtain an estimate of difficulty hearing in noise that is representative of real-world performance. Sperry, Wiley & Chial (1997) found that a meaningful speech competitor had a significantly more adverse effect on word recognition performance compared to non-meaningful competitors (e.g.
  • Page 85 GSI AudioStar Pro Clinical Audiometer 2. The mean SNR-50 value on six normal-hearing adult subjects was within 1.5 dB of their grand average on the Alpha-2 recordings; 3. The mean SNR-50 value on eight high-frequency-loss adult subjects was within 2 dB of their grand average on the Alpha-2 recordings;...

  • Page 86: Reliability (Statistics Made Useful)

    Figure 5 shows a plot of across-subject QuickSIN Beta averages for 25 normal- hearing adult subjects at each filtering condition. The twelve lists without an X exhibited SNR-50 values at each filtering condition that fell within ± 2.2 dB of the grand average.
  • Page 87 GSI AudioStar Pro Clinical Audiometer (four times out of five) the “true” score (obtained from many lists) will be within 1.8 dB of the single-list test score. Statisticians would say we have “an 80% confidence level” that the true QuickSIN score will be within + 1.8 dB of the measured score.

  • Page 88: Appendix A

    To improve from 80% to 95% confidence level at a given criterion requires an approximate doubling of test time. Example: Two lists in each condition gives a 1.8 dB critical difference at the 80% confidence level; four lists in each condition provide 1.9 dB at the 95% confidence level, and five lists in each condition provide 1.7 dB at the 95% confidence level.

  • Page 89: References

    GSI AudioStar Pro Clinical Audiometer References Bentler, R (2000). List Equivalency and Test-Retest Reliability of the Speech in Noise Test. Am J Audiol, 9 (2): 84- 100. Braida, L (2000). Personal communication. Egan, JP (1944). Articulation Testing Methods II. Office of Research and Development, Report 3802. PB 22848.

  • Page 90: Appendix 2: Emc Compatibility

    AudioStar Pro. Install and operate the GSI AudioStar Pro according to the EMC information presented on this page and the next 4 pages. The GSI AudioStar Pro has been tested for EMC emissions and immunity as a standalone instrument. Do not use the GSI AudioStar Pro adjacent to or stacked with other electronic equipment.

  • Page 91: Guidance And Manufacturer's Declaration - Electromagnetic Emissions

    Guidance and Manufacturer’s Declaration - Electromagnetic Emissions The GSI AudioStar Pro is intended for use in the electromagnetic environment specified below. The customer or the user of the GSI AudioStar Pro should assure that it is used in such an environment.

  • Page 92: Guidance And Manufacturer's Declaration - Electromagnetic Immunity

    Guidance and Manufacturer’s Declaration - Electromagnetic Immunity The GSI AudioStar Pro is intended for use in the electromagnetic environment specified below. The customer or the user of the AudioStar Pro should assure that it is used in such an environment.

  • Page 93: Guidance And Manufacturer's Declaration - Electromagnetic Immunity

    To assess the electromagnetic environment due to fixed RF transmitters, an electromagnetic site survey should be considered. If the measured field strength in the location in which the AudioStar Pro is used exceeds the applicable RF compliance level above, the AudioStar Pro should be observed to verify normal operation. If abnormal performance is observed, additional measures may be necessary, such as re-orienting or relocating the AudioStar Pro.

  • Page 94: Appendix 3: Reference Materials

    Appendix 3: Reference Materials Moore, B.C.J. (2004). Dead regions in the Cochlea: Conceptual Foundations, Diagnosis, and Clinical Applications. J Ear and Hearing 2004; 25; 98-116. USA. Lippincott Williams & Wilkins. Moore, B.C.J., Glasberg, B.R., Stone, M.A. (2004). New Version of the TEN Test With Calibrations in dB HL. J Ear and Hearing 2004;...

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