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Interacoustics Affinity2.0 Quick Manuals

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Hearing Aid Fitting
Quick Guides
Affinity
&
2.0
Callisto™:
• Introduction to Quick Guides
• Basic Audiometry
• AC440 Protocol Setup
• Print Report
• Customised Printout Setup
• TEN Test
• QuickSIN
• A Beginners Guide to Real Ear Measures
• REM BSA
• REM440 Protocol Setup
• Directionality REM440
• RECD
• Visible Speech Mapping
• HIT440 Instructions
• HIT440 Protocol Setup
• Skull Simulator
• FM Transparency
• FM Ear Level
8105216 - 1 - 12/2013

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Summary of Contents for Interacoustics Affinity2.0

  • Page 1 Hearing Aid Fitting Quick Guides Affinity & Callisto™: • Introduction to Quick Guides • Basic Audiometry • AC440 Protocol Setup • Print Report • Customised Printout Setup • TEN Test • QuickSIN • A Beginners Guide to Real Ear Measures • REM BSA • REM440 Protocol Setup • Directionality REM440 • RECD • Visible Speech Mapping • HIT440 Instructions • HIT440 Protocol Setup • Skull Simulator • FM Transparency • FM Ear Level 8105216 - 1 - 12/2013...
  • Page 3 Overall, Audiology is changing; it is now often the case that a pure tone audiogram alone cannot identify the entirety of your patient’s problems. It is for that reason that Interacoustics have invested time and effort into providing the additional tests and features outlined in this document within the Affinity and Callisto. They can allow the tester to have a greater scope and insight when assessing and rehabilitating.
  • Page 5 Quick Guide - Basic Tone Audiometry The purpose of this document is to provide a quick guide for basic functions of the AC440 Audiometry modules for the Affinity /Equinox and Callisto™ suites. This Quick Guide will focus on Tone Audiometry as well as a basic introduction to the various icons, tools and menus available.
  • Page 6 Choose “Rev” to present the masking noise continuously.  It is also possible to turn on Automasking or Masking help For more information on the Automasking/Masking Help, please refer to the Quick Guide, available on www.interacoustics.com Item No. 8105081 – 12/2013 Page 2 of 3...
  • Page 7 Navigation: Tools and functions 1. Menu: Click on Menu to access other Audiometry Special tests by going to Menu│Tests. 2. Protocols and Sessions: Choose the desired test and choose the session to display. Current Session is always the active session. Highlight and select older sessions to be displayed on the active audiogram for comparison.
  • Page 9 Quick Guide - AC440 Protocol Setup Introduction This Quick Guide is intended to provide basic instructions on how to work with protocol setups in the AC440 module in the Affinity and Callisto™ suites. Working with Individual Setups (Test Protocols) There are many different demands and wishes regarding how an audiometer should both function and appear depending on the specific situation and national standards.
  • Page 10 Once in the AC440 Setup, available tests will be listed to the left. Each test can be unfolded to access its options. Each test contains the following options: Startup: These are the settings in which the test will start up. Common: Allows for setting up more general settings of the specific test.
  • Page 11 Creating new Protocols/Changing a Test Protocol Permanently 1. Click Menu | Setup | AC440 setup to enter the Main setup. 2. Click New to create a new test protocol. 3. A pop up window will appear, asking which settings to copy. Choose the protocol to be copied from the drop down menu and re-name the new protocol.

  • Page 12: Changing A Test Protocol Temporarily

    Changing a Test Protocol Temporarily To make changes to the setup temporarily: 1. From the drop down menu, ensure that the desired protocol to be changed is the chosen one. 2. Enter the Temporary Setup by clicking the button in the front screen (or alternatively select Menu/Setup/Temporary setup).

  • Page 13: Importing And Exporting Test Protocols

    Importing and Exporting Test Protocols The AC440 also allows you to import and export test protocols to other AC440 users. Exporting a Test Protocol: Go to the AC440 Setup (Menu | Setup | AC440 setup). Click on Export. Select if the file is to be saved as “read only”. In this case the protocol file is locked and the clinician receiving it will not be able to make changes to it.
  • Page 14 Importing a Test Protocol: Go to the AC440 Setup (Menu | Setup | AC440 setup). Click Import and browse to the location on the PC or USB where the test protocol file has been saved. Click Open. The test protocol will then appear under Name. After saving it by clicking OK the test protocol can be selected in the List of defined protocols in the front screen.
  • Page 15 Quick Guide – Print Reports Using the Print Wizard In the Print Wizard you have the option to create customized print templates which can be linked to individual protocols for quick printing. The Print Wizard can be reached in two ways. a.
  • Page 16 3. Factory default templates are recognized by the lock icon. They ensure that you always have a standard template and do not need to create a customized one. However, in order to edit these default templates, they need to be saved under a new name. User defined/created templates can be set to Read-only (showing the lock icon), by right clicking on the template and selecting Read-only from the drop down list.
  • Page 17 Quick Guide – Customised Printout Setup Introduction This Quick Guide is intended to give a brief introduction on how to create and configure custom print layouts in the Affinity and Callisto™ software suites. The Affinity and Callisto™ software suites have the ability to allow custom print layouts to be created and used alongside the VIOT Suite and Titan™...
  • Page 18 4. In the new window you will find Print Setup in the bottom left corner. Please press this to open the Print Wizard. Item No. 8105084 12/2013 Page 2 of 14...
  • Page 19 Designing a New Customised Print Template 1. Now that you are in the Print Wizard you will see the below screen: This screen is further clarified by the quick guide titled; ‘Quick Guide – Print Report’. 2. Click on the blank page in the top right of the screen to create a new print layout. This action will open a new screen.
  • Page 20 3. Once in this new screen you will see the elements which you can add to the layout on the left of the screen. These are ordered by their corresponding test module, for example everything to input into the print template to do with the AUD module can be found under AUD.
  • Page 21 4. Please select an object from the left to draw onto your page. In this example I am using an Audiogram. Once Audiogram has been clicked you will need to draw it to your desired size onto the page. 5. Once drawn you will be able to move it to your desired position and also right click to define the parameters of what information it displays.
  • Page 22 Also, when right clicking on an element you have the options to rotate that element and also toggle the surrounding border. 6. Once you have clicked in all of your elements and have configured them to your preference you will need to organise them.
  • Page 23 7. However, if you left-click on one element and then hold Control on your keyboard and left clik on another you will then be able to activate the rest of this tool bar. This opens up the sizing and alignment options to you.
  • Page 24 Notice how the first element clicked is taking settings (size) from the second element. Item No. 8105084 12/2013 Page 8 of 14...
  • Page 25 8. Continue to click and add further aspects of your print template to your preference. Once completed you can add information on your clinic (via a blank Test box) and even a logo. This can be done via the General sub-tab on the left of the screen.
  • Page 26 Item No. 8105084 12/2013 Page 10 of 14...
  • Page 27 9. Finally I will add a text box below the logo to show the sites address and contact details. Item No. 8105084 12/2013 Page 11 of 14...
  • Page 28 You can also alter the font and formatting of the text and how it will appear on your print layout in this section. This text box will be common to this print layout when it is printed from in the future. Item No.
  • Page 29 Saving your print template Now that you have completed your print template and have designed it to your preference and requirements you can click on Save or Save As… in the top left of the screen. 2. As this is a new print layout Save will perform the same action as Save As… and a small window will appear requesting you to title your print layout.
  • Page 30 Once you have titled this layout and Ok is clicked it will appear in your Print Wizard as a new layout. Please see the Quick Guide titled ‘Quick Guide – Print Report’ on how to set this as a default or a favorite. Should you require additional information on this then please see the Affinity and Callisto™...
  • Page 31 , Affinity and Callisto™. This Quick Guide is based on a white paper that was written for Interacoustics by Brian C.J. Moore (2009) What is the TEN test? The TEN(HL) test was developed to provide clinicians with a quick and easy way to identify cochlear dead regions.

  • Page 32: Test Procedure

    Test Procedure NOTE: the TEN test is performed ipsilaterally, meaning that the tone and the noise are presented in the same ear. It can only be conducted with TDH39, DD45 and Insert earphones headphones Setup: 1. Launch the Affinity /Callisto™ suite from your patient management system, Noah or OtoAccess™. 2.
  • Page 33 Moore, B. C. J. (2001). "Dead regions in the cochlea: Diagnosis, perceptual consequences, and implications for the fitting of hearing aids," Trends Amplif. 5, 1–34. Moore, B. C. J. (2009). “Audiometer Implementation of the TEN (HL) Test for Diagnosing Cochlear Dead Regions” . White Paper for Interacoustics. Available on http://support.interacoustics.com/downloads/additional/ten_test_white_paper_cochlear_dead_regions. www.interacoustics.com Item No.
  • Page 35 Quick Guide to QuickSIN - Basic SNR Loss Testing The purpose of this document is to provide a quick guide and an overview on using the Callisto™ system to perform QuickSIN testing. The QuickSIN test was developed to  Provide a one-minute estimate of SNR loss ...
  • Page 36 There are up to 3 practice lists to help familiarise the test for the client, lists 1-12 are to be used for basic QuickSIN testing and they can be selected from the drop down menu highlighted below. Please select your list from this drop down menu Press start to begin the first sentence on the selected list.
  • Page 37 Averaging several QuickSIN lists (only lists 1-12 at the same intensity level) will improve the reliability of the results. This will be particularly useful for comparing two conditions i.e. Aided vs. Unaided or before and after hearing aid adjustments have been made. ...
  • Page 39 Quick Guide – A Beginners Guide to Real Ear Measures (REM) Introduction This Quick Guide is intended to provide information at a beginner level to assist the reader in their understanding of Real Ear Measures (REM). It will also explain some of the common terminology used for REM and Callisto™...
  • Page 40 This process sets up the conditions to allow comparison between the external microphone and the internal probe microphone. Once placed in the ear canal this will show the effect of the ear canal and hearing device amplification. The calibration can be checked in the upcoming REUG measure through running a measurement in the same configuration as the calibration.
  • Page 41 Performing this measurement allows you to make a consideration of the ears natural amplification of sound; this ensures that you are not fitting your hearing aid to over-amplify in certain regions of the frequency response. 3. Real Ear Occluded Gain (REOG) – this measurement involves the placement of the hearing device on the ear but muted/off.
  • Page 42 4. Real Ear Aided Response (REAR) or Real Ear Aided Gain (REAG) – this is a measure which involves the enabled/on hearing device being positioned on the ear with the ear-piece inserted as per normal use and the probe microphone inserted. This allows measurement of the hearing device’s amplification effect within the patients’...
  • Page 43 5. Real Ear Insertion Gain (REIG) – this is a measure which is performed in the exact same configuration as the REAR and REAG above but requires the REUG to be performed in advance of it. It does this because it only displays the dB gain view of what the hearing aid is doing and removing the REUR acoustics from this display.
  • Page 44 When do I use Calibrate for Open Fit? When performing REM the stimulus needs to be maintained at the point of the patients head to ensure an accurate measurement is made. This can be difficult when making REM measurements with Open Fit Hearing Aids because there is a lot of sound which leaks out of the ear canal and on to the reference microphone.
  • Page 45 Quick Guide – Adult REM The purpose of this document is to provide a quick guide for the REM procedure stated by the British Society of Audiology (BSA) for the REM440 Real-Ear Measurement module in the Affinity and Callisto™ Suites. This Quick Guide will focus on the method and order of the REM measurements specified by this guideline.
  • Page 46 Verification using Insertion Gain (REM Adult UK) 1. Choose the REM Adult UK protocol, this is correctly configured according to the BSA Guidelines. 2. Choose the appropriate options with in the Fitting Prescription Settings window, which will appear automatically when a REM protocol is chosen: It is here that you will configure your prescription settings to acknowledge aspects of the patients amplification setup, i.e.
  • Page 47 Measure the REUR Place the hearing aid in the patient’s ear, but ensure that it is muted. Click on REOR and click on START to measure the Real-Ear Occluded Response. The REOR shows the occluding effect of the ear canal in relation to the patients’ natural ear resonance. It can also be used as an effective method of checking whether you are blocking the probe tube ahead of beginning your measurements.
  • Page 48 Verification of Open Fittings (REM Adult Open Fit UK) 1. Choose the REM Adult Open Fit UK protocol: 2. Choose the appropriate options within the Fitting Prescription Settings window, which will appear automatically when a REM protocol is chosen. Select the desired verification signal. 4.
  • Page 49 6. Perform the Open Fit calibration: Open Fit Calibration steps: 1. Position the probe tube in the patient’s ear canal. 2. Place the hearing aid, connected to the hearing aid fitting software, inside the patient’s ear. 3. MUTE or SWITCH OFF the hearing aid. 4.
  • Page 50 Verification using the REAR protocol 1. Choose the REM Adult Aided Response UK protocol: 2. Choose the appropriate options with in the Fitting Prescription Settings window, which will appear automatically when a REM protocol is chosen: 3. Select the verification signal. 4.
  • Page 51 For a more detailed description of how to use the REM440 module, please refer to the following documents: Instructions for Use for Affinity /Equinox Instructions for Use for Callisto™ Additional Information for Affinity /Equinox Additional Information for Callisto™ Item No. 8105088 – 12/2013 Page 7 of 7...
  • Page 53 Quick Guide – REM440 Protocol Setup This Quick Guide is intended to give a brief introduction on how to work with, create or edit protocols in the Affinity and Callisto™ software suites. Introduction The Affinity and Callisto™ software suites all have pre-defined protocols. Most of these protocols can easily be copied, modified or created from new.
  • Page 54 3. Name the test protocol setup in the Selected protocol section. 4. Select the tests to be included in the test protocol. Mark a test by clicking on it and press the Add. Double clicking on a test will also select it. Choose all the tests for the test protocol using this procedure. 5.
  • Page 55 In this window you can manipulate your individual parameters which relate to the test within your test battery including renaming, input level, stimulus type, curve smoothing index etc. Once you have set and are happy with this, please click Apply to save and keep the screen open or OK to save and Exit. Pressing Cancel will exit the window and discard your amendments.
  • Page 56 Note: Prior to creating a new test protocol you may wish to select a protocol type in the Protocols to view dropdown list. This function is practical if you for example wish to create a new protocol based on elements from a pre-existing protocol prior to creation.
  • Page 57 Importing and Exporting Test Protocols The REM440 also allows you to import and export test protocols to other REM440 users. Exporting a Test Protocol: Go to the REM440 Setup (Menu | Setup | REM440 setup). Click on Export. Select if the file is to be saved as “read only”. In this case the protocol file is locked and the clinician receiving it will not be able to make changes to it.
  • Page 58 Importing a Test Protocol: Go to the REM440 Setup (Menu | Setup | REM440 setup). Click Import and browse to the location on the PC or USB where the test protocol file has been saved. Click Open. The test protocol will then appear under Name. After saving it by clicking OK the test protocol can be selected in the List of defined protocols in the front screen.
  • Page 59 Quick Guide - REM Directionality Test This Quick Guide is indented to provide information on how to conduct directional testing of hearing aids, using the REM440 module of the Affinity and Callisto™ Software Suites. Directionality Test using REM440 Directionality Test using Real Ear Measurements 1.
  • Page 60 11. Place the client in front of the loudspeaker as shown on the picture. Click OK and front microphone curve will be recorded. New instructions will immediately appear. Turn the client around and click OK. To add the directionality test to an existing protocol: 1.
  • Page 61 8. Adjust the Settings if desired . Choose the appropriate setup if using a back speaker (Affinity only) Item No. 8105090 – 12/2013 Page 3 of 3...
  • Page 63 Quick Guide – RECD with REM440 Introduction The Real Ear to Coupler Difference (RECD) is a measurement that accounts for the decibel difference across frequencies between SPL measured in the coupler and the SPL measure in the real ear, produced by the same transducer generating the same signal.
  • Page 64 1. Launch the Affinity or Callisto™ software from your patient management system, Noah or OtoAccess™ and click on the REM440 tab 2. From the Protocols and Sessions drop down list, choose a protocol that includes the RECD (ex: Pediatric Aided Response) 3.
  • Page 65 Figure 2: Measuring the RECD using the SPL probe with Affinity (a) and Callisto™ (b) 1. Launch the Affinity or Callisto™ software from your patient management system, Noah or OtoAccess™ and click on the REM440 tab 2. From the Protocols and Sessions drop down list, choose a protocol that includes the RECD (ex: Pediatric Aided Response) 3.
  • Page 66 Using age appropriate predicted RECD values If it is impossible to get an RECD measurement (ex: child is crying or uncooperative), it is recommended to use age appropriate predicted RECDs. 1. Launch the Affinity or Callisto™ software from your patient management system, Noah or OtoAccess™ and click on the REM440 tab 2.
  • Page 67 For more information, please consult the Affinity Additional Info and Callisto™ Additional Info documents, available on our website www.interacoustics.com Not all hearing aid manufacturers’ software support the import of RECDs. If unsure, check with the hearing aid manufacturer. Item No. 8105091 – 12/2013...
  • Page 68 References Bagatto MP. Optimizing your RECD measurements.The Hearing Journal 2001; 54: 32, 34-36. Bagatto MP. The Essentials of Fitting Hearing Aids to Babies. Seminars in Hearing 2013; 34:1, 19-26 Bagatto MP (2007). Learning the Art to Apply the Science: Common Questions Related to Pediatric Hearing Instrument Fitting.
  • Page 69 Quick Guide – Visible Speech Mapping The purpose of this Quick Guide is to give clinicians a short introduction to Visible Speech Mapping during the hearing aid fitting process and patient counseling. Introduction Verification of the hearing aid fitting is a very important part of the fitting process. To try to make this process a bit easier, rather than using traditional real-ear measurements, hearing care professionals can use the Visible and Callisto™...

  • Page 70: Measurement Steps

    Measurement Steps Figure 1: the Visible Speech Mapping screen 1. Choose the Visible Speech Mapping protocol from the drop down menu. 2. Choose the appropriate options with in the Fitting Prescription Settings window, which will appear automatically when the Speech Mapping protocol is chosen: The fitting formula can also be changed by expanding the “advanced view”...
  • Page 71 3. To verify the fitting, select the ISTS signal (to use a calibrated speech-like signal for verification) . 4. Click on the Visible Speech Mapping button at the bottom left of the screen. If using an Open Fitting configuration, click on the “Calibrate for Open Fit” before proceeding with verification. 5.
  • Page 72 Counseling overlays.  Use visuals to help explain the hearing loss to patients.  Adding visual information helps understanding of amplification and hearing loss.  Choose from “Familiar Sounds” examples, Phonemes and Speech Banana. Unaided vs Aided.  Easily visually demonstrate the Unaided Aided difference between unprocessed vs...
  • Page 73 Adaptive feature example 2: Demonstrating Noise Reduction.  Red Curve: Unaided and Aided with Noise Reduction feature OFF.  Blue Curve: Unaided and Aided with Noise Reduction feature set to MAX. Dynamic range.  The dynamic range is the range between the softest sound the ear can detect and the loudest sound the ear UCLs...
  • Page 75 Introduction The purpose of this Quick Guide is to provide guidelines on how to conduct basic technical measurements of hearing instruments using the HIT440 module for the Interacoustics Affinity hearing aid analyzer. NOTE: Hearing instruments needs to be in FULL ON GAIN MODE/TEST MODE in order to compare the results to the hearing aid manufacturers’...
  • Page 76 ITE/Open Fittings/Receiver in the ear Required Items: 1. The Affinity hardware. 2. The HIT440 software. 3. A coupler microphone. 4. A coupler (usually 2cc). 5. An ITE adaptor for 2cc coupler. 6. A reference microphone. 7. Blue putty to secure the hearing instrument to the 2cc coupler.

  • Page 77: Comparing To The Manufacturers Specification Sheets

    Test procedure: 1. Position the hearing aids and reference microphone as shown in the pictures above. 2. Select the desired test protocol in the List of Protocols 3. Select Test Ear 4. Select START 5. Please wait for all tests of the selected protocol to be performed. 6.
  • Page 78 Testing for battery drain 1. Insert the battery pill inside the hearing aid (example below). 2. Connect the battery pill into the red socket in the Affinity test chamber. 3. If the test is included in the test sequence, it will be measured automatically. Connect the battery pill For more information on HIT440, please refer to the Affinity Additional Information document.
  • Page 79 Quick Guide – HIT440 Protocol Setup This Quick Guide is intended to give a brief introduction on how to work with, create or edit protocols in the Affinity and Callisto™ software suites. Introduction The Affinity and Callisto™ software suites all have pre-defined protocols. Most of these protocols can easily be copied, modified or created from new.
  • Page 80 3. Name the test protocol setup in the Selected protocol section. 4. Select the tests to be included in the test protocol. Mark a test by clicking on it and press the Add. Double clicking on a test will also select it. Choose all the tests for the test protocol using this procedure. 5.
  • Page 81 8. In General settings find the following additional options: Display combined screen allows for comparing different curves by default in the same graph. The option is also available from the front screen. Which curves to compare can be setup individually (see section Error! Reference source not found.).
  • Page 83 Quick Guide – SKS10 Skull Simulator Introduction This Quick Guide is intended to provide guidelines on how to use the Interacoustics SKS10 Skull Simulator for bone anchored hearing devices. Background Info How do bone anchored systems work? Bone anchored hearing systems transfer sound to the cochlea via direct bone conduction, bypassing the outer and middle ear.
  • Page 84  Optional: the TBS25 passive HIT box. Installing the Skull Simulator License in the HIT440 Software: 1. After purchasing the SKS10 and the license, please send Interacoustics (service@interacoustics.com) the serial number. 2. To copy the serial number: go to Menu/Help/About, click on License and select “Copy s/n”;...
  • Page 85 Activating the new HIT license: 1. Go to HIT module/Menu/Help/About. 2. Click on License. 3. Paste the new license number under HIT/New license. The Skull protocol might be hidden in the software. To activate it: 1. Go to HIT/Menu/Setup/HIT440 setup. 2.
  • Page 86 Setting up the bone anchored devices Using the SKS10 with the Affinity 1. Connect the skull simulator to its external power supply. 2. Plug the power supply into the wall socket. 3. Place the skull simulator in the test chamber. 4.
  • Page 87 2. To re-initiate the Skull Coupler Setup Guide startup window, go to Menu/Setup/General Setup and insert checkmark in the “Show setup guide” box. For further information on the SKS10 and creating or customising protocols, please refer to the Interacoustics Additional Information document.
  • Page 89 The purpose of this Quick Guide is to describe how to verify FM transparency of FM system using the Hearing Aid Analyzer. FM Transparency can be defined as “The condition in which equal Interacoustics Affinity inputs to the FM and hearing aid microphones produce equal outputs from the hearing aid.”...
  • Page 90 Step 1: HA Alone 1. Select the HA Alone test. 2. Attach the hearing aid to the coupler/coupler microphone. 3. Position the hearing aid in the test chamber. 4. Click START to measure the output of the hearing aid (red curve). Step 2: HA + Receiver 1.
  • Page 91 Note: the two curves should be very similar to each other Step 3: FM Mic + HA 1. Remove the hearing aid, still attached to the coupler, from the test box. 2. Position the FM microphone inside the test box, in front of the reference microphone. 3.
  • Page 92 Step 4: Calculate the average difference 1. Click on the table mode icon to activate Table Mode. 2. Once in table mode, calculate the difference between 750 Hz, 1000 Hz and 2000 Hz and 3. Calculate the average. 4. If the average is 2 dB or less, FM transparency is achieved. 5.

  • Page 93: Ear Level, Fm-Only

    Ear Level, FM-only The purpose of this Quick Guide is to describe how to do real-ear verification of Ear Level FM systems (Oticon Amigo Star, Phonak iSense) with the Interacoustics Affinity Hearing Aid Analyzer, using FM-specific targets. The verification method is based on the AAA Clinical Practice Guidelines for Remote Microphone Hearing Assistance Technologies for Children and Youth Birth to 21 Years.
  • Page 94 2. From Noah or from the Affinity suite AUD screen, enter the audiogram. The audiogram will be within the range of normal/near normal. 3. Click on the REM tab. 4. Once in the REM screen, select the “Ear Level, FM only” protocol from the drop down list. 5.
  • Page 95 8. Measure the REAR and match target between 1kHz and 4kHz. Select the appropriate FM-specific target:  FM Boom or  FM Chest  the choice should reflect what is used with the FM system being tested Measure the REAR by clicking the Start button. Adjust volume control on the FM receiver to match the targets between 1kHz and 4kHz.
  • Page 96 References: American Academy of Audiology (April 2011). Clinical Practice Guidelines: Remote Microphone Hearing Assistance Technologies for Children and Youth Birth to 21 Years (includes supplement A). http://www.audiology.org/resources/documentlibrary/Documents/HAT_Guidelines_Supplement_A.pdf Angelo, Kamilla & Fuglholt, Merethe L. (2013). Amigo Star. A New Ear-Level FM-Only Receiver. Pediatric Knowlegdge Brief.

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Callisto