Patent Application
20050085343
The present invention relates generally to rehabilitation of an individual having a medical condition and, more particularly, to using quantified representations of personal environment dimensions and physical dimensions characteristics of an individual having a medical condition to select a rehabilitation plan for the individual.
It is well known that rehabilitation of many medical conditions, such as hearing loss, central nervous system conditions, high cholesterol, diabetes, obesity, etc., usually requires an individual having a medical condition to perform certain actions that are designed to alleviate the condition, but will not necessarily result in curing or eliminating the condition. For example, an individual suffering from the medical condition of hearing loss is unlikely to ever have perfect hearing again, despite the use of an instrument, such as a programmable hearing aid, that may be prescribed to address the physical aspects of the condition. The approach that the medical community typically takes to rehabilitate a medical condition, such as hearing loss, is to prescribe use of an instrument that addresses only some of the physical aspects of the medical condition. The instrument is designed to address the physical aspects of the medical condition, so as to alleviate the medical condition sufficiently to enable the individual to attain what most persons would consider to be a more normal lifestyle. The instrument will successfully address the physical aspects of the medical condition so long as the individual uses the instrument in the manner specifically required for the instrument.
For example, hearing loss is a medical condition for which a hearing compensation device, such as a hearing aid, is usually prescribed to address the physical inability of an individual to satisfactorily hear certain sound frequencies. It is believed that more than 25 million Americans suffer from hearing loss, including one out of four people older than sixty-five. Hearing loss may come from infections, strokes, head injuries, some medicines, tumors, other medical problems or even excessive earwax. In addition, hearing loss can result from repeated exposure to very loud noise, such as music, power tools or jet engines. Changes in the way the ear works as a person ages can also affect hearing.
To determine what kind of hearing loss an individual has and whether all the parts of the individual's ear are functioning, a physician usually has the individual take a hearing test. A health care professional that specializes in hearing, such as an audiologist, often gives these tests. As well known in the art, the audiologist performs a professional hearing test by using an audiometer, i.e., a sound-stimulus-producing device, to generate pure tones at various frequencies between 125 Hz and 12,000 Hz that are representative of a variety of frequency bands. The intensity or volume of the pure tones is varied until the individual can just barely detect the presence of the tone. For each pure tone, the intensity at which the individual can just barely detect the presence of the tone is known as the individual's air conduction threshold of hearing. Although the threshold of hearing is only one physical dimension among several physical dimensions that characterize the physical aspects of an individual's hearing loss, it is the predominant measure traditionally used to acoustically fit a hearing compensation device, such as a hearing aid.
Various hearing compensation devices currently are available that can be programmed for rehabilitation of an individual having hearing loss. In general, the hearing aid devices are programmed based on hearing tests performed on an individual to determine the individual's hearing loss at a plurality of frequency ranges. For example, U.S. Pat. No. 6,201,875, incorporated by reference herein, describes a method of fitting a hearing compensation device that includes selecting a plurality of loudness levels for a plurality of frequency ranges and comparing each loudness level for each frequency for perceived sameness. The loudness levels may then be adjusted as needed to achieve perceived sameness across the frequency spectrum. A gain curve for each frequency is calculated from the selected plurality of loudness levels. As part of the fitting process, the individual sits at a computer or similar graphical user interface with a hearing aid in an ear and responds to loudness of tones in each of twelve frequency ranges. The hearing aid itself emits these test tones in one frequency range at a time, and the individual adjusts the volume based on individual preferences. This process is repeated for all twelve frequency ranges, and the results are sent with the hearing aid to its manufacturer for programming. The programmed hearing aid is shipped back to the audiologist and provided to the individual with instructions for operation.
It is noted that the steps performed to program a hearing aid, such as described in the '875 patent, are analogous to the steps that an optometrist would perform to fit eyeglasses to an individual suffering from vision loss. For example, the optometrist queries an individual as to the clarity of eye charts, adjusts the focal correction by providing a temporary lens and then continues to repeat these steps until the focal correction is optimized. The optimal correction, called a prescription, is then applied to corrective lenses, which is the instrument that will be manufactured for the individual to address the physical aspects of vision loss.
Although the unique and personal characteristics of an individual can significantly impact the successful rehabilitation of a medical condition that includes the use of an instrument to treat physical aspects of the condition, the medical community does not typically formally integrate and use the results of an assessment of an individual's unique and personal characteristics, in combination with the results of an assessment of the individual's physical dimensions relating to the medical condition, into the selection of a rehabilitation plan for the medical condition. For example, when a hearing aid is fitted to an individual, such as described in the '875 patent, the unique and personal characteristics of the individual are not formally used to design a rehabilitation plan for the individual. The unique and personal characteristics of each individual, or an individual's personal environment dimensions, can include, for example, the individual's preferences and dislikes, tendencies, psychological profile and the like.
For example, audiologists currently do not select or develop aural rehabilitation plans in view of such personal environment dimensions as an individual's skill in understanding speech, known as speech intelligibility; the likelihood that the individual will experience ambient noise in real-world settings, such as restaurants, theaters and conference rooms, that interfere with hearing conversations, and also the nature of the ambient noise that the individual will experience; the impact of an individual's psychological makeup on the hearing improvement process, such as an individual's perception of his own hearing loss severity and the accompanying motivation to correct it; the ability of an individual to trace the source of a sound, known as localization; an individual's preferences and tendencies, such as in adapting to new technologies, or persistency or practice with adopting new behaviors;; an individual's personal preferences in the trade-off between the appearance and the performance of a rehabilitation instrument; and an individual's perception and preference for sound quality. Consequently, many individuals currently are dissatisfied with the perceived improvement to their hearing resulting from use of hearing aid devices.
It has been found that, in many circumstances, an individual prescribed a hearing aid is under the impression that use of the hearing aid will result in a level of rehabilitation that will be satisfactory to the individual, but that the individual's personal and unique characteristics that have not been accounted for in the prescription of the hearing aid make it unlikely that the individual will ever achieve such level of rehabilitation. The individual thus becomes disappointed, oftentimes very quickly following initial use of the hearing aid. As is human nature, the individual expresses his dissatisfaction concerning the use of a hearing aid to others. The perceptions of other individuals who could benefit from use of a hearing are now adversely affected based on hearing of another's dissatisfaction, such that others will be less likely to seek medical assistance in connection with their hearing loss. Studies have found that about twenty percent of hearing aid users return their hearing aids for refunds, while the remainder experience diminished hearing aid performance and, thus, diminished quality of life.
In addition, current techniques for rehabilitating a medical condition, such as a hearing loss, do not include an easily usable and readily accessible means to store systematically in a database individual-specific information concerning personal environment and physical dimensions characteristics and the rehabilitation plans prescribed to the individual. Further, current medical condition rehabilitation techniques do not provide for ease of access and use of such a rehabilitation database for learning purposes, and also for selecting a rehabilitation plan for an individual with a medical condition based on similarities between the characteristics of the personal environment and physical dimensions of the individual and the characteristics of the personal environment and physical dimensions corresponding to rehabilitation plans included in the database.
Therefore, there exists a need for integrating quantified results of an assessment of personal environment and physical dimensions of individuals into the process of selecting a rehabilitation plan for an individual, and for providing ease of access to a database containing rehabilitation plans indexed by corresponding personal environment and physical dimensions information for use in the rehabilitation plan selection process.
In accordance with the present invention, a plan for rehabilitating an individual having a medical condition is selected by assessing personal environment and physical dimensions of the individual, and then quantifying measurement information obtained from the assessment of the dimensions so that scores representative of the results of the respective assessments can be generated. The scores for the respective personal environment and physical dimensions of the individual, and individual profile information also obtained from the assessments, are then used to select a rehabilitation plan.
In a preferred embodiment, the selection of a rehabilitation plan includes searching a rehabilitation database for the medical condition to identify a matching rehabilitation plan. The database includes, for each of a plurality of personal environment and physical dimensions associated with the medical condition, a plurality of rehabilitation plans previously prescribed to patients, and optionally rehabilitation plans generated from performing interpolations using information from previously prescribed rehabilitation plans. The stored rehabilitation plans are indexed by scores generated from the results of respective personal environment and physical dimensions assessments of patients, or by scores for respective personal environment and physical dimensions generated from the interpolations. A rehabilitation plan is selected from the database by matching the score for at least a first of the assessed dimensions of the individual with the score corresponding to a stored rehabilitation plan associated with the first dimension, where the first dimension is either a personal environment dimension or a physical dimension.
In a further preferred embodiment, the database is updated using feedback obtained from an individual to whom a selected rehabilitation plan is prescribed and progress results concerning the prescribed plan. For example, the plan prescribed to the individual, or a variation of the prescribed plan modified to the individual's preferences, is identified in the database indexed by the dimension the prescribed plan addresses and also the individual's score for the dimension. In addition, the prescribed plans in the database can include annotation information describing rehabilitative progress of the individual and whether a rehabilitation goal was successfully attained.
In a preferred embodiment, an assessment of an individual having hearing loss is performed to obtain measurement information on physical dimensions of hearing loss, such as on volume and pitch, and also on personal environment dimensions that can impact use of a hearing aid device to address the physical aspects of hearing loss. The personal environment dimensions can include, for example, speech intelligibility, real-world needs, critical success factors, localization, appearance and performance trade-offs and quality preferences. The measurement information for each of the respective dimensions is normalized into a diagnostic metric from which diagnostic scores can be generated for use in searching a centralized database that can be remotely accessed using conventional communications techniques. The database includes previously prescribed aural rehabilitation plans indexed by diagnostic scores obtained from the results of assessments of respective physical and personal environment dimensions of the patients to whom the rehabilitation plans were respectively prescribed. The database optionally includes aural rehabilitation plans, and associated score information, generated from interpolations performed using information representative of the previously prescribed aural rehabilitations stored in the database. The database is searched with respect to one or more of the dimensions of the individual to retrieve stored aural rehabilitation plans that match the characteristics of the respective one or more dimensions of the individual. The selected plans that are prescribed constitute a custom aural rehabilitation program, which preferably includes the use of a hearing aid device, and that the individual is more likely to follow and result in the individual attaining what the individual considers to be a satisfactory level of rehabilitation. The retrieved plans further preferably includes annotation information that can guide an audiologist whether the plan is suitable for the individual, in view of the individual's personal environment and physical dimensions characteristics.
Other objects and advantages of the present invention will be apparent from the following detailed description of the presently preferred embodiments, which description should be considered in conjunction with the accompanying drawings in which like references indicate similar elements and in which:
The present invention provides for system and method for selecting a rehabilitation plan for an individual having a medical condition in view of the unique and personal and also physical characteristics of the individual. The invention is based on the recognition that unique and personal characteristics of the individual, or the individual's personal environment dimensions, and also physical characteristics of the individual, or the individual's physical dimensions, can impact whether an instrument, such as an electronic device, medication, diet control or controlled exercise of selected physical structures in the individual's body, for addressing physical dimensions of the medical condition, will be effectively used by the individual as prescribed so that the individual succeeds in attaining a level of rehabilitation that the individual considers to be satisfactory. The invention integrates results of an assessment of the personal environment and physical dimensions of an individual having a medical condition into the selection of a rehabilitation plan by quantifying measurement information obtained from the assessments so that scores representative of the individual's dimensions characteristics can be used to select a rehabilitation plan. The selection of a rehabilitation plan preferably includes the use of a database containing previously prescribed rehabilitation plans, where the plans are indexed by quantified results of assessments of the personal environment and physical dimensions of the respective patients to whom the corresponding plans were prescribed. The database also can contain rehabilitation plans, with associated indexing information, developed using interpolation techniques from the previously prescribed rehabilitation plan information stored in the database. Further, the database preferably includes annotation information for respective rehabilitation plans that can further guide a decision as to which of a plurality of plans selected from the database should be prescribed to an individual. By customizing the rehabilitation plan in view of the results of an assessment of the dimensions of the individual having the medical condition, one or more rehabilitation plans can be selected to form a rehabilitation program for the individual that results in higher rates of success in attaining a level of rehabilitation that the individual considers to be satisfactory.
The personal environment dimensions of an individual can be categorized as constituting an individual's emotions or “heart,” an individual's rational or objective behavior or “mind” and an individual's physical characteristics or “body.” These categories of dimensions are assessed to assist in the identification of a rehabilitation plan that, for the specific individual, will likely succeed in attaining a level of rehabilitation that the individual considers to be satisfactory, in view of the personal environment dimension characteristics of the individual.
The heart category of personal environment dimensions is associated with emotions and perceptions, such as whether an individual would feel old or young based on use of a specific instrument as part of a rehabilitation plan. The heart category also can represent the degree of emotional anguish an individual suffers based on the medical condition itself. Successful rehabilitation is more likely, i.e, an individual is more likely to use a prescribed instrument, when the type of prescribed instrument is selected in view of the individual's perceptions. For example, an aural rehabilitation plan is likely to be more successful if the decision to prescribe a larger versus a smaller, relatively invisible hearing aid is made in view of an individual's perceptions concerning the size of the device itself.
The mind category of personal environment dimensions is associated with an individual's rational thinking, such as how an individual would tradeoff a larger or smaller instrument with the price of the instrument.
The body category of personal environment dimensions is associated with the impact that the application of the instrument to one portion of the individual's body will have on the rest of the individual's body, such as, for example, whether the individual will have to make additional physical adjustments based on application of the instrument. The individual may find that the application of a particular instrument to one part of the body requires time for training and exercising other unrelated parts of the body. For example, an individual may be more tolerant of a hearing aid that is located behind the ear versus in the ear canal, because the former creates less discomfort. In addition, an individual having hearing loss and limited manual dexterity may prefer a remotely controllable hearing aid that is larger to allow for ease of adjustment and battery replacement.
For purposes of highlighting the features of the present invention, the present inventive technique of integrating quantified personal environment and physical dimensions characteristics of an individual with a medical condition into the selection of a rehabilitation plan, where the plan preferably includes application of an instrument for treating a physical aspect of the medical condition, is described below in connection with selection of an aural rehabilitation plan for an individual having hearing loss in view of personal environment and physical dimensions characteristics of the individual, where the aural rehabilitation plan preferably includes use of a programmable or non-programmable hearing aid. It is to be understood that the present inventive technique can be readily applied to selecting a rehabilitation plan for any of various medical conditions, for example, central nervous systems conditions such as Alzheimer's disease, cardiological conditions, high cholesterol, joint replacement, diabetes, hypertension, schizophrenia and other like medical conditions, for which an instrument likely will be prescribed to address physical aspects of the condition to alleviate the condition at least in part.
Typically, the individual 105 on whom an assessment is performed in connection with each of the metrics 100 has experienced loss of hearing due to physical damage of hearing cilia inside one or both ears. Measurement information obtained from an assessment of the-respective dimensions is used to define corresponding metrics 100, and then an individual's scores for the respective metrics 100 are generated also based on the measurement information. The measurement information for the respectively assessed dimensions is preferably converted to a scale in a range which provides that the individual's scores for all of the metrics can be applied as a percentage between a lowest possible score 190 and a perfect score 120.
The dimensions corresponding to the metrics 100 in
Volume metric 111 corresponds to an assessment of a physical dimension and represents the amplitude of a sound wave. Pitch metric 112 also corresponds to an assessment of a physical dimension and represents the frequency of a sound wave. The measurement information used to define the metrics 111 and 112 is obtained by an audiologist using techniques for determining an individual's capability of hearing within an amplitude and frequency range that are part of standard audiologist tests today. For example, in a well known method of testing for volume and pitch hearing loss in individuals, the threshold of an individual's hearing is typically measured using a calibrated sound-stimulus-producing device and calibrated headphones, which are known as an audiometer. The matrix of measurements represents a variation of pitch versus volume.
Referring again to
Speech intelligibility metric 113 corresponds to an assessment of a personal environment dimension and quantifies the ability of an individual to hear speech sounds, such as spoken words and sentences, as part of a normal conversation. Tests to determine speech intelligibility metric 113 are conducted by an expert, such as an audiological professional, using a series of most commonly spoken words and sentences. The individual with hearing loss responds as to how he or she hears selected words and sentences. As is well known in the art, typical speech sounds occur in the form of a “speech banana.” Assessment of speech intelligibility is performed by reading a series of words to an individual at various amplitudes and looking for an accurate hearing response from the individual. The responses are readily converted into measurements at different volumes for each of the spoken words. The areas of the “speech banana” that contain letter sounds that are harder for the subject to hear are noted. In accordance with the present invention, a rehabilitation plan corresponding to an assessment of the speech intelligibility dimension will emphasize these letter sounds that are harder to hear, such as by including more practice words for these letter sounds than the letter sounds that the individual can hear more easily.
Real-world needs metric 114 corresponds to an assessment of a personal environment dimension and quantifies the hearing capability of an individual that corresponds to the individual's lifestyle and behavioral needs. It is well known that hearing capabilities are significantly affected by lifestyle. For example, an elderly individual living in a rural area can be exposed to a quieter environment and has a different real-world needs metric 114 than a younger individual working as a construction worker in an urban area. Measurement information for defining the real-world needs metric 114 can be obtained by simply asking a series of questions of the individual. The questions can include, for example, whether the individual spends significant amounts of time watching television, attending religious ceremonies or attending cocktail parties.
Individual's critical success factors metric 115 corresponds to an assessment of a personal environment dimension and quantifies an individual's preferences, tendencies and capabilities. Individual's critical success factors metric 115 can be thoroughly tested by highly qualified professionals, such as audiologists, using simple or complex tests prepared by psychologists. For example, a simple test determines the preference of the individual 105 for electronic devices, whereas more complex tests, such as Myers-Briggs or the Learning Styles Inventory, determine the impulsivity, preferred learning style, discipline and attention span of the individual 105. Measurement information for defining an individual's critical success factors metric 115 can be obtained by simply noting responses of the individual to a series of questions.
Localization metric 116 corresponds to an assessment of a personal environment dimension and quantifies the ability of an individual to trace the source of a sound. For example, an individual with a deficient localization metric 116 may incorrectly identify the dimensions of an enclosed room due to his inability to trace sound rebounding from the walls, or may incorrectly judge the rate or direction of an approaching vehicle. State-of-the-art virtual reality (VR) techniques can be used to test and assess the individual's localization metric 116. For example, one VR technique employs a head-mounted display (HMD), which consists of two miniature displays that are mounted in front of the user's eyes with a head mount. Special optics enable the user to view the miniature screens. The HMD also contains two headphones, so that the user may also experience the virtual environment aurally. The HMD is normally fitted with a head tracker. The position (x, y, z) and orientation (yaw, pitch, roll) of the user's head is tracked by means of the head tracker. As the user looks around, the position and orientation information is continuously relayed to the host computer. The computer calculates the appropriate view (virtual camera view) that the user should see in the virtual environment, and this is displayed on the miniature displays. Based on these procedures, the audiologist can easily obtain measurement information need to define the individual's localization metric 116.
Appearance/performance trade-off metric 117 corresponds to an assessment of a personal environment dimension and quantifies an individual's personal preference regarding the trade-off between the appearance and the performance of a device. For example, a first group of individuals may prefer electronic devices that are aesthetically pleasing and may not be very concerned with the performance of the devices or whether the devices are visible to others or not; a second group of individuals may prefer performance over aesthetics or visibility; and a third group may prefer to balance all of the above aspects. Measurement information to define the appearance/performance trade-off metric 117 can be obtained, for example, by noting an individual's responses to a series of questions.
Quality preferences metric 118 corresponds to an assessment of a personal environment dimension and quantifies an individual's perception of and preference for sound quality. An individual's preferences for a specific quality sound can be viewed in terms of a personal graphic equalizer, where the individual has the capability to hear all sound frequencies but prefers to emphasize or deemphasize certain frequencies. Quality preferences metric 118 can be tested by exposing an individual to a wide range of tones and sounds and asking him whether he likes the quality of the sound. For example, an individual who dislikes sounds like air conditioning in a room can be tested for his preferences relating to a variety of sounds that are similar to air conditioning in a room. Measurement information for defining the quality preferences metric 118 can be obtained simply by noting responses to a series of questions. Based on this measurement information, a rehabilitation plan can be selected in accordance with the present invention that includes use of a hearing aid that is programmed to reduce the volume of the disliked sounds.
Similar to the normalization performed on the volume versus pitch measurement information for defining the volume metric 111 and pitch metric 112, the measurement information obtained from an assessment of the personal environment dimensions corresponding to the metrics 113-118 are respectively normalized to define signal metrics that are each a linear scale from lowest possible score 190 to a perfect score 120.
Referring to
If an objective measurement can be performed to determine what constitutes a perfect condition for a dimension, such as can be performed for the dimensions corresponding to the metrics 111, 112, 113 and 116, a lowest possible score 190, a diagnostic score 140, a goal score 130 and a perfect score 120 can be generated for the metric corresponding to the dimension. For example, for the metric 112 which concerns an individual's capability to hear sound at all frequencies, the lowest possible score 190 is the circumstance where the individual is incapable of hearing sound at any frequency; the diagnostic score 140 is the individual's reduced capability to hear at specific frequencies due to hearing loss; the goal score 130 is the best possible level of rehabilitation, i.e., improvement in hearing, for the individual in view of the hearing loss suffered by using a hearing aid as part of a rehabilitation plan; and the perfect score 120 is a level that constitutes perfect hearing, i.e., the capability to hear all frequencies, and that the individual can never attain even through use of hearing aid because of the physical loss inside an ear. The generation of a diagnostic score based on the measurement information corresponding to each of the metrics 111, 112, 113 and 116 could be, for example, as simple as summing all scores where a perfect hearing score is 100% and worst case hearing is 0%.
Alternatively, if an objective measurement cannot be performed to determine what constitutes a perfect score for the dimension, such as cannot be performed for the dimensions corresponding to the metrics 114, 115 and 117, only a lowest possible score 190, a diagnostic score 140 and a goal score 130 can be generated for the metric corresponding to the dimension. For these dimensions, the perfect score 120 does not exist, or otherwise is considered to be the same as the goal score 130.
In addition, even if an objective measurement cannot be performed to determine what constitutes a perfect score for the dimension, in some circumstances a perfect score 120 can still be generated for the metric corresponding to the dimension. For example, for the quality preferences metric 118, a perfect score 120 can constitute hearing performance that the individual previously was capable of attaining and remembers but, in view of the hearing loss, cannot ever again achieve, even with use of a hearing aid.
Referring still to
As discussed below, the individual's score for the metric 117 can be used to select rehabilitation plans to be included in an overall rehabilitation program that will improve the chances of successful use of a hearing aid device by the individual. For example, based on the diagnostic score for the metric 117, the audiologist would only prescribe the use of an aesthetically pleasing, basic functioning hearing aid and accordingly select other rehabilitation plans to supplement the functional shortcomings of the prescribed hearing aid. In addition, the goal score and diagnostic score for the metric 117 can reflect the willingness of the individual to potentially accept larger hearing aids. An appropriate rehabilitation plan for the metric 117, based on such scores, would involve use of a moderately sized hearing aid.
For purposes of illustration,
In addition, line 137 connects the goal scores 130 for each of the metrics 100 and line 127 connects the perfect scores 120 for each of the metrics. The bounded area defined between the lines 137 and 147 corresponds to a cumulative goal score 135. The cumulative goal score 135, for example, can constitute the sum of the absolute difference between the goal scores 130 and the diagnostic scores 140 for each of the metrics 100. The bounded area defined between the lines 127 and 137 corresponds to a cumulative perfect score 125. The cumulative score 125 represents the individual's overall present hearing capabilities and, for example, can constitute the sum of the absolute difference between the perfect scores 120 and the diagnostic scores 130 for each of the metrics 100. Thus, the cumulative score 135 represents how much overall improvement to hearing is possible relative to the cumulative score 145 if the individual uses a hearing aid as a part of rehabilitation plan selected in accordance with the present invention. The cumulative score 125 represents hearing performance that the individual can never regain. It is to be understood that the metrics 100 shown in
Steps to reach a goal 150 is the step-by-step path necessary for the individual 105 to progress from diagnostic score 140 to goal score 130 for a specific metric. Typically, steps to reach goal 150 is an aural rehabilitation plan prescribed by a speech pathologist for the individual 105, Aural rehabilitation plans are gradual training and acclimation programs designed to bring individuals with hearing loss up to their best possible hearing level.
Referring again to
In accordance with the present invention, measurement information obtained from assessing the personal environment and physical dimensions of an individual is quantified so that it can be readily used to assist and guide in the selection of a rehabilitation plan for an individual having a medical condition, such as, for example, the selection of an aural rehabilitation plan by an audiologist. Scores corresponding to diagnostics metrics generated from the measurement information, and also profile information obtained from the assessments, are used to select rehabilitation plans that, in combination, form a rehabilitation program that has a high probability of successfully attaining a level of rehabilitation that the individual considers to be satisfactory. The selected rehabilitation plans impact the type of instrument selected to treat physical aspects of the medical condition and the type of rehabilitation efforts that the individual is directed to perform in connection with the use of the selected instrument. As the rehabilitation program is customized to the individual, the individual is more likely to adhere to the rehabilitative program, which includes use of the instrument. Thus, for an individual having hearing loss, scores generated for the metrics corresponding to respective personal environment and physical dimensions of the individual assist in the selection of a rehabilitation plan including the use of a hearing aid. As the individual's personal environment and physical dimensions characteristics are accounted for in the selection of rehabilitation plans, the individual is highly likely to use the hearing aid and also perform other treatment actions required by the rehabilitation plans so as to successfully reach a level of rehabilitation that is in accordance with the individual's expectations.
The hearing test unit 215 can be used to perform conventional hearing tests on an individual 105, and to ask questions of an individual, such as Myers-Briggs test questions, and record the individual's responses. For example, the conventional monitor 235 can graphically display test frequencies and amplitudes for the individual 105 during testing or list questions with potential answers for selection by the individual.
The network 250 is a standard Internet connection, or alternatively is a WAN, LAN or other network configuration. Network 250 is the communication infrastructure between central hearing health computer system 260 and hearing test unit 215. Network 250 allows central hearing health computer system 260 to be located remotely from hearing test unit 215, thereby allowing central hearing health computer system 260 the opportunity to serve as a central point for a large number of test administration computers 220.
Test administration computer 220 runs a series of current hearing test programs 240, which can be suitably updated from the system 260 over the network 250, and stores the results of the tests in the database 263 of central hearing health computer system 260. Test administration computer 220 may also have optional local database storage (not shown) that can temporarily store test results.
Central hearing health computer system 260 is a centrally located computer system that is connected to network 250, and is capable of performing all normal computer functions, such as reading and writing data to database 263, reading and writing data to a display monitor (not shown), communicating through network 250 and executing stored programs to access and use data stored in database 263.
Database 263 preferably is a central database repository within central hearing health computer system 260. The data stored within database 263 is classified into three main areas, namely, individual profile information 265, individual test results 267 and aural rehabilitation plans 269 individual profile information 265 includes, for example, such personal information as an individual's name, contact information, age and career profile. Individual test results 267 are the results of hearing tests or hearing loss related assessments performed on individuals with hearing loss. Aural rehabilitation plans 269 stores rehabilitation plans prescribed to individuals, preferably in respective aural rehabilitation plan records. The plan included in a record is indexed by individual profile information and diagnostic and goal scores corresponding to assessment of respective personal environment and physical dimensions characteristics of the individual to which the plan was prescribed. In addition, in an alternative preferred embodiment, the rehabilitation plans stored in the plans 269 include rehabilitation plans, and associated indexing information, generated by performing conventional interpolation techniques using information concerning the previously prescribed rehabilitation plans stored in the records in the plans 269. The use of the database 263 to select a rehabilitation plan is explained in greater detail in the text accompanying the description of
Referring again to
Thus, the individual 105 is assessed for physical dimensions associated with hearing loss, and scores are computed based on measurement information obtained from the assessment respectively for each of the volume metric 111 and pitch metric 112. In addition, preferably while the individual with hearing loss is also at the audiologist's office, the personal environment dimensions of the individual 105 are assessed, such as the dimensions corresponding to a speech intelligibility metric 113, real-world needs metric 114, individual's critical success factors metric 115, localization metric 116, appearance/performance trade-off metric 117 and quality preferences metric 118, and then respective scores are computed based on measurement information obtained from these assessments. All of the scores generated for the respective metrics 100 of the individual 105 are stored in individual test results 267 and used to select one or more aural rehabilitation plans. The selected aural rehabilitation plans, indexed by the individual profile information and the individual's scores for the diagnostic metrics corresponding to the selected plans, are stored as aural rehabilitation plan records in the rehabilitation plans 269. As described below in connection with
It is to be understood that the assessments of physical dimensions and personal environment dimensions performed in connection with selecting an aural rehabilitation plan for an individual with hearing loss are readily adaptable for use in assessing physical dimensions and personal environment dimensions of an individual having any type of medical condition in connection with prescribing an overall rehabilitation program including rehabilitation plans that may or may not involve use of an instrument addressing physical aspects of the condition.
In accordance with the present invention, the audiologist 310 selects a rehabilitation plan for the individual 105 by searching the database 263, which contains, a plurality of rehabilitation plans indexed by an profile information and scores for the metrics corresponding to respective personal environment and physical dimensions associated with the condition of hearing loss. The selecting includes comparing the profile information and also the scores for a metric corresponding to at least a first of the physical dimensions and the personal environment dimensions for the individual 105 with rehabilitation plans in the plans 269 associated with the same metric, and then selecting, from the compared plans of the plans 269, a plan having matching profile information and scores.
Referring to
Referring to
Following step 410, in step 415 the hearing test unit 215 performs the programs 240, or alternatively the audiologist 310 performs offline computations, to process the raw measurement information obtained from the assessments of step 410 so as to define metrics 100 corresponding to the respectively assessed dimensions. Preferably, the metrics 100 are defined by quantifying the measurement information obtained for the respective dimensions in the manner described with reference to
Following step 415, in step 420, for each of the metrics 100, the diagnostic score 140 and any goal score 150 for the individual 105 are stored as individual test results 267.
Then in step 430, the central hearing health computer system 260 determines an aural rehabilitation plan for the individual 105. For purposes of illustration, step 430 is performed by evaluating tables similar to an exemplary virtual database table 500, as shown in
For ease reference and clarity, the method 400 is described below in connection with the use of previously prescribed aural rehabilitation plans stored as tables 500, and with the understanding that method 400 can also include processing of aural rehabilitation plans that are generated using interpolation techniques and are similarly indexed in the table 500. Referring again to
In the preferred embodiment, aural rehabilitation plans 269 of database 263 contain multiple copies of table 500 for at least thousands of individuals having hearing loss. Referring to
Following step 430, in step 440 the audiologist 310 prescribes the rehabilitation plan selected in step 430 to the individual 105. In the preferred embodiment, audiologist 310 prescribes rehabilitation plan 560 to the individual 105 over several counseling sessions, where each counseling session marks an improvement milestone for the individual's hearing, such that at the end of the final counseling session, the individual's hearing is at goal score 130.
For example, if D3 in the table 500 for the individual 105 corresponds to the speech intelligibility metric 113, the corresponding rehabilitation plan 560 can be a pre-recorded compact disc that teaches the individual 105 to listen and train his brain to interpret an improved version of a series of words and sentences to bring speech intelligibility metric 113 from diagnostic score 140 to goal score 130. Rehabilitation trajectory 550 can last for three weeks, where audiologist 310 meets with the individual 105 once a week to study the individual's learning progression and to receive feedback from the individual on adding or removing training words from the compact disc.
In a further embodiment, the plan 560 for D3 is prescribed in view of the plan 560 for D5, which corresponds to the critical success factors metric 115. By aggregating selected rehabilitation plans Into a rehabilitation program, the likelihood of successful use of the compact disc prescribed under D3 is heightened. For example, where the plan 560 for D5 indicates a preference for use of electronic devices, the plan 560 for D3 using a learning compact disc can be supplemented with other electronic devices to further promote the progress of rehabilitation, in view of the individual's preference for electronic devices.
In still a further preferred embodiment, the plan 560 for D3 is prescribed in view of the plan 560 for D7, which corresponds to the quality preferences metric 118, and the plan 560 for D1, which corresponds to the volume metric 111. For example, based on the selected plans, a hearing aid for an individual with hearing loss is programmed to increase amplification gradually, over time, consistent with the implementation of a treatment plan where the individual uses a prerecorded CD to train and learn to hear only some of the various frequencies that the individual previously could not hear because of the onset of hearing loss. The rehabilitation plan for D3 sets the expectation for rehabilitation for the individual to a level associated with relearning a first set of frequencies. The relearning is achieved over a first period through use of the CD, which is specifically programmed to address only the first set of frequencies, the and the hearing aid that has been programmed to a first amplification level. As a result, the individual is highly likely to adhere to the overall rehabilitation program, and use the hearing aid which is programmed in view of the individual's personal environment dimensions characteristics, because the individual will be able to note that rehabilitative progress is being made. The recognition of rehabilitative progress by an individual is particularly critical during the initial period of rehabilitation, because during this period the individual is most likely to become frustrated by a rehabilitation plan, such as one requiring the use of a hearing aid, and stop using the hearing aid or not perform the treatments prescribed by the plans. After the first rehabilitation goal is reached, the individual can be re-assessed and based on the reassessment, the hearing aid would be programmed to increase amplification and a CD specific to other frequencies would be prescribed. The iteration of this process maintains the individual's interest and incentive to continue with rehabilitation, because the level of rehabilitation reached at each stage is consistent with what the individual considers to be satisfactory.
In a further preferred embodiment, if the system 260 retrieves several selected plans, the audiologist uses his judgment to prescribe one or more of the selected plans that should lead to the most improvement with the least amount of effort by the individual.
In an alternative preferred embodiment, the system 260 uses the diagnostic and goal scores of the individual 105 to compute a cumulative diagnostic score and a cumulative goal score, and uses the cumulative scores to adjust the rehabilitation plans prescribed to the individual. For example, if the cumulative goal score is relatively large and the cumulative diagnostic score is relatively small, the rehabilitation plans can be customized to ensure the individual is aware that much rehabilitative effort will be needed and prescribe treatments that should achieve highly noticeable change and do not initially overwhelm the individual to cause the individual to abandon a rehabilitation program.
Thus, the scores that can generated for corresponding personal environment and physical dimensions characteristics of an individual help customize and optimize an overall rehabilitation program for an individual. The scores constitute predictors of what treatments, ie, rehabilitation plans from the database 263, when prescribed to the individual 105, will result in the individual using the hearing aid and adhering to treatments directed by the selected rehabilitation plans so as to successfully attain a level of rehabilitation that is satisfactory to the individual.
Following step 440, in step 450 the audiologist 310 updates the database 263 based on any feedback that the individual 105 provides based on the aural rehabilitation plan suggested in step 440 or the resulting progress of rehabilitation. The feedback can be provided before, during or after the individual 105 implements the prescribed plan. The updating of the database 263 can be done through standard PC input/output devices such as keyboard 230 and monitor 235. This feedback is particularly useful to annotate the individual's aural rehabilitation plan record, or the plan record containing the selected aural rehabilitation plan prescribed to the individual, to ensure the completeness and accuracy of the aural rehabilitation plan records in the aural rehabilitation plans 269 within database 263.
The updating can include, for example, defining a new aural rehabilitation plan record in a table 500 for the individual. For example, the record can be for the diagnostic metric D1 and identify a treatment plan in the plan 560 that is a modified version of the plan suggested in the step 440. In a further preferred embodiment, to ensure the individual's 105 satisfaction, in all the counseling sessions, the individual 105 can provide feedback and the audiologist uses the feedback to update the rehabilitation plan 560 and rehabilitation trajectory 550 based on the individual's experience.
In a further preferred embodiment, the computer system 260 processes the information in the database 263 to generate predictive modeling data associated with use of hearing aids and hearing aid accessories. Specifically, the computer system 260 processes the information contained in the profiles 520, the scores 530 and 540 and the corresponding plans 560 for the respective metrics 510 in each of the tables 500 in the database 263 to predict how an individual, having a profile and associated scores for each of the respective diagnostic metrics, will use a particular hearing aid and what hearing aid accessories can be cross-sold to the individual based on how the individual will use the hearing aid. Methods of using predictive modeling to increase sales revenues are well known in the art. See, for example, U.S. Pat. No. 5,930,764, incorporated by reference herein.
Although preferred embodiments of the present invention have been described and illustrated, it will be apparent to those skilled in the art that various modifications may be made without departing from the principles of the invention.
This application claims the benefit of U.S. Provisional Application Nos. 60/482,675 filed Jun. 26, 2003 and 60/482,159 filed Jun. 24, 2003, assigned to the assignee of this application and incorporated by reference herein. The subject matter of U.S. patent application Ser. No. ______, filed Jun. 24, 2004 and entitled “METHOD AND SYSTEM FOR USING A DATABASE CONTAINING REHABILITATION PLANS INDEXED ACROSS MULTIPLE DIMENSIONS”, assigned to the assignee of this application, is related to this application.
| Number | Date | Country | |
|---|---|---|---|
| 60482675 | Jun 2003 | US | |
| 60482159 | Jun 2003 | US |
