U.S. patent application number 10/876173 was filed with the patent office on 2005-04-21 for method and system for rehabilitating a medical condition across multiple dimensions.
Invention is credited to Burrows, Mark, Cronin, John, Narsana, Tushar, Singarayar, John Anthony.
Application Number | 20050085343 10/876173 |
Document ID | / |
Family ID | 33567636 |
Filed Date | 2005-04-21 |
United States Patent
Application |
20050085343 |
Kind Code |
A1 |
Burrows, Mark ; et
al. |
April 21, 2005 |
Method and system for rehabilitating a medical condition across
multiple dimensions
Abstract
A rehabilitation plan for an individual with a medical condition
is selected in view of physical dimensions and personal environment
dimensions of the individual that can impact successful use of an
instrument for treating the medical condition. Measurement results
obtained from assessments of respective physical dimensions and
personal environment dimensions of the individual are used to
define respective diagnostics metrics, and also to generate
diagnostic and goal scores for the respective metrics. A
rehabilitation plan for the individual is selected in view of the
diagnostic and goal scores with the intention of increasing an
individual's compatibility with the plan and the likelihood of
success for rehabilitation. The selection of a rehabilitation plan
can include querying a database including previously prescribed
rehabilitation plans indexed by physical and personal environment
dimensions characteristics of respective patients that were
prescribed the rehabilitation plans.
Inventors: |
Burrows, Mark; (Bryn Mawr,
PA) ; Cronin, John; (Milton, VT) ; Narsana,
Tushar; (Winooski, VT) ; Singarayar, John
Anthony; (Skillman, NJ) |
Correspondence
Address: |
NORRIS MCLAUGHLIN & MARCUS, P.A.
P O BOX 1018
SOMERVILLE
NJ
08876
|
Family ID: |
33567636 |
Appl. No.: |
10/876173 |
Filed: |
June 24, 2004 |
Related U.S. Patent Documents
|
|
|
|
|
|
Application
Number |
Filing Date |
Patent Number |
|
|
60482675 |
Jun 26, 2003 |
|
|
|
60482159 |
Jun 24, 2003 |
|
|
|
Current U.S.
Class: |
482/1 ;
482/8 |
Current CPC
Class: |
A61B 5/00 20130101; G16H
20/30 20180101; G16H 50/70 20180101; G16H 70/20 20180101 |
Class at
Publication: |
482/001 ;
482/008 |
International
Class: |
A63B 015/02; A63B
071/00; A63B 021/002 |
Claims
What is claimed is:
1. A method for selecting a rehabilitation plan for an individual
having a medical condition comprising: assessing personal
environment dimensions and physical dimensions of an individual
having a medical condition to obtain measurement information;
defining diagnostic metrics corresponding to the respective
assessed dimensions based on the measurement information;
generating scores for the individual for the respective metrics
based on the measurement information; and selecting a
rehabilitation plan for the individual using the score
corresponding to at least a first of the assessed dimensions of the
individual.
2. The method of claim 1 wherein the selecting further comprises:
searching a database containing rehabilitation plans for the
medical condition, wherein the database includes, for respective
physical dimensions and personal environment dimensions associated
with the medical condition, scores corresponding to respective
stored rehabilitation plans, and matching the score for the at
least first assessed dimension for the individual with a score in
the database corresponding to a stored rehabilitation plan
associated with the at least first assessed dimension, wherein the
matched rehabilitation plan is selected as a rehabilitation plan
for the individual.
3. The method of claim 1, wherein the generated scores and the
scores in the database each comprise at least one of a diagnostic
score and a goal score and the stored rehabilitation plans comprise
previously prescribed rehabilitation plans and, optionally,
interpolated rehabilitation plans.
4. The method of claim 1, wherein the measurement information for
the assessed dimensions of the individual includes profile
information.
5. The method of claim 2, wherein the measurement information for
the assessed dimensions of the individual includes profile
information and wherein the database includes, for the respective
physical dimensions and personal environment dimensions, profile
information corresponding to the stored rehabilitation plans that
correspond to the respective scores, and wherein the database
further includes annotation information for at least one of the
stored rehabilitation plans.
6. The method of claim 2 further comprising: updating the database
based on feedback received from the individual for which the
rehabilitation plan was selected.
7. The method of claim 1 further comprising: selecting an
instrument for use in rehabilitating the individual based on the
selected rehabilitation plan.
8. A method for selecting an aural rehabilitation plan for an
individual with hearing loss comprising: assessing personal
environment dimensions and physical dimensions of an individual
with hearing loss to obtain measurement information; defining
diagnostic metrics corresponding to the respective assessed
dimensions based on the measurement information; generating scores
for the individual for the respective metrics based on the
measurement information; and selecting an aural rehabilitation plan
for the individual using the score corresponding to at least a
first of the assessed dimensions of the individual.
9. The method of claim 8, wherein the selecting further comprises:
searching a hearing loss rehabilitation plan database, wherein the
database includes, for respective physical dimensions and personal
environment dimensions associated with hearing loss, scores
corresponding to respective stored aural rehabilitation plans, and
matching the score for the at least first of the assessed
dimensions for the individual with a score in the database
corresponding to a stored aural rehabilitation plan associated with
the at least first assessed dimension, wherein the matched aural
rehabilitation plan is selected as an aural rehabilitation plan for
the individual.
10. The method of claim 9, wherein the defining the diagnostic
metrics includes normalizing the measurement information obtained
for each of the assessed dimensions into a linear scale signal
metric, wherein the generated scores and the scores in the database
each comprise at least one of a diagnostic score and a goal score
and wherein the stored aural rehabilitation plans comprise
previously prescribed aural rehabilitation plans and, optionally,
interpolated aural rehabilitation plans.
11. The method of claim 10, wherein the measurement information for
the assessed dimensions of the individual includes profile
information, wherein the database includes, for the respective
physical dimensions and personal environment dimensions, profile
information corresponding to the aural rehabilitation plans that
correspond to the respective scores and wherein the database
further includes annotation information for at least one of the
stored rehabilitation plans.
12. The method of claim 8, wherein the personal environment
dimensions associated with hearing loss include at least two of
speech intelligibility, real world needs, critical success factors,
localization, appearance/performance trade-offs and quality
preferences.
13. The method of claim 8 further comprising: selecting a
programmable hearing aid for use in rehabilitating the individual
based on the selected rehabilitation plan.
14. A system for selecting a rehabilitation plan for an individual
having a medical comprising: a rehabilitation plan selection means
having communications capabilities, wherein the selection means
includes a rehabilitation plan database containing, for respective
physical dimensions and personal environment dimensions associated
with a medical condition, scores corresponding to respective stored
rehabilitation plans; and wherein the selection means, in response
to a selection request including a score corresponding to at least
a first of assessed physical and personal environment dimensions of
a individual having the medical condition, selects a rehabilitation
plan for the individual by matching the score for the first
assessed dimension of the individual with a score in the database
corresponding to a stored rehabilitation plan associated with the
at least first assessed dimension, wherein the matched
rehabilitation plan is selected as a rehabilitation plan for the
individual.
15. The system of claim 14 further comprising: a dimensions
assessment means having communications capabilities and for
coupling to the selection means, wherein the assessment means
includes programs for assessing at least one of physical dimensions
and personal environment dimensions of the individual requestor to
obtain measurement information, wherein metrics corresponding to
the respective assessed dimensions can be defined and scores for
the respective metrics can be generated for the individual based on
the measurement information, and wherein the assessment means is
operable to transmit the selection request to the selection
means.
16. The system of claim 15, wherein the generated scores and the
scores in the database each comprise at least one of a diagnostic
score and a goal score, wherein the stored rehabilitation plans
comprise previously prescribed rehabilitation plans and,
optionally, interpolated rehabilitation plans, and wherein the
database further includes annotation information for at least one
of the stored rehabilitation plans.
17. The system of claim 14, wherein the selection means updates the
database based on feedback or rehabilitative progress results
concerning the individual requestor for whom the rehabilitation
plan was selected.
18. The system of claim 14, wherein the selection means, based on
the score of the requestor for the at least first assessed
dimension, identifies an instrument for use in conjunction with the
selected rehabilitation plan.
19. A system for selecting an aural rehabilitation plan for an
individual having hearing loss comprising: an aural rehabilitation
plan selections means having communications capabilities, wherein
the selection means includes an aural rehabilitation plan database
containing, for respective physical dimensions and personal
environment dimensions associated with hearing loss, scores
corresponding to respective stored aural rehabilitation plans; and
wherein the selection means, in response to a selection request
including a score corresponding to at least a first assessed
physical and personal environment dimension of an individual having
hearing loss, selects an aural rehabilitation plan for the
individual by matching the score for the first assessed dimension
of the individual with a score in the database corresponding to a
stored aural rehabilitation plan associated with the at least first
assessed dimension, wherein the matched rehabilitation plan is
selected as the aural rehabilitation plan for the individual.
20. The system of claim 19 further comprising: a dimensions
assessment means having communications capabilities and for
coupling to the selection means, wherein the assessment means
includes programs for assessing at least one of physical dimensions
and personal environment dimensions of the individual requestor to
obtain measurement information, wherein metrics corresponding to
the respective dimensions can be defined and scores for the
respective metrics can be generated for the individual based on the
measurement information, wherein the assessment means is operable
to transmit the selection request to the selection means, and
wherein the database further includes annotation information for at
least one of the stored rehabilitation plans.
21. The system of claim 20, wherein the assessed personal
environment dimensions of the individual with hearing loss includes
at least two of speech intelligibility, real-world needs, critical
success factors, localization, appearance and performance
trade-offs and quality preferences.
22. A system for selecting a rehabilitation plan for an individual
with a medical condition comprising a database accessible via
communication means, wherein the database includes individual
profiles, diagnostics scores, goal scores and annotation
information corresponding to respective previously prescribed
rehabilitation plans for respective physical dimensions and
personal environment dimensions of an individual with the medical
condition, wherein the database is searchable for matching
individual profiles, diagnostic scores and goal scores associated
with at least a first of assessed physical dimensions and personal
environment dimensions of an individual to profiles, diagnostic
scores and goals scores that correspond to respective previously
prescribed rehabilitation plans for the at least first assessed
dimension, wherein the corresponding rehabilitation plan is
selected as a rehabilitation plan for the requester.
Description
CROSS REFERENCE TO RELATED APPLICATIONS
[0001] 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.
FIELD OF THE INVENTION
[0002] 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.
BACKGROUND OF THE INVENTION
[0003] 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.
[0004] 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.
[0005] 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.
[0006] 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.
[0007] 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.
[0008] 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.
[0009] 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.
[0010] 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.
[0011] 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.
[0012] 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.
SUMMARY OF THE INVENTION
[0013] 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.
[0014] 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.
[0015] 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.
[0016] 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.
BRIEF DESCRIPTION OF THE DRAWINGS
[0017] 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:
[0018] FIG. 1 illustrates a set of metrics used to diagnostically
assess physical dimensions and personal environment dimensions of
the hearing capability of an individual in accordance with the
present invention.
[0019] FIG. 2 is a preferred hearing health system, in accordance
with present invention, for assessing physical dimensions and
personal environment dimensions of an individual having hearing
loss and for storing in a centralized database profile information
and scores representative of the measurement information obtained
from the assessments.
[0020] FIG. 3 is a system diagram of an audiologist prescribing an
aural rehabilitation plan to an individual with hearing loss using
the hearing health system of FIG. 2.
[0021] FIG. 4 illustrates a preferred method of prescribing an
aural rehabilitation plan to an individual with hearing loss using
the hearing health system of FIG. 2.
[0022] FIG. 5 is a representative database table for use in
developing an aural rehabilitation program for an individual with
hearing loss using the system of FIG. 2.
[0023] FIG. 6 is a table showing an individual hearing profile at
specific amplitudes for numerous frequencies and the amplification
factor needed to adjust hearing to a normal level.
DETAILED DESCRIPTION OF THE INVENTION
[0024] 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.
[0025] 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.
[0026] 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.
[0027] 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.
[0028] 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.
[0029] 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.
[0030] FIG. 1 is a graphical representation of an exemplary set of
metrics 100 for an individual with hearing loss 105 that is used,
in accordance with the present inventive technique, to quantify the
results of diagnostic assessments of personal environment
dimensions and physical dimensions of the individual 105. As
discussed in detail below, diagnostic scores and goal scores
generated for the respective metrics, and individual profile
information, are used to select rehabilitation plans for the
individual. The selected plans are included in a rehabilitation
program that is customized to the individual's personal environment
and physical dimensions characteristics and, thus, has a high
likelihood of successfully attaining a level of rehabilitation that
is satisfactory to the individual. Referring to FIG. 1, the metrics
100 include metrics corresponding to physical dimensions of hearing
loss, such as a volume metric 111 and a pitch metric 112, and
metrics corresponding to personal environment dimensions of an
individual having hearing loss, such as a speech intelligibility
metric 113, a real-world needs metric 114, an individual's critical
success factors metric 115, a localization metric 116, an
appearance and performance trade-off metric 117 and a quality
preferences metric 118. In an alternative preferred embodiment, the
physical dimension associated with an individual's ear canal
characteristics is also assessed for defining a corresponding
metric. In addition, FIG. 1 shows, for each of the metrics 100, a
goal score 130, a diagnostic score 140, a plurality of steps to
reach a goal 150 and a lowest possible score 190. Further, FIG. 1
identifies which of the metrics 100 constitute binaural impact
indications 160.
[0031] 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.
[0032] The dimensions corresponding to the metrics 100 in FIG. 1,
which are exemplary metrics corresponding to physical and personal
environment dimensions associated with an individual having hearing
loss, are described in detail below.
[0033] 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.
[0034] FIG. 6 illustrates an exemplary database table 600 that is
typically used to store pitch versus volume testing data that can
be used to define the metrics 111 and 112 and generate individual
scores for the metrics 111 and 112 in accordance with the present
invention. Referring to FIG. 6, the table 600 includes a normal
hearing frequency range 610, an amplitude range 620, an example of
individual hearing values 630, an example of normal hearing values
640, an example of amplification factors 650 and an example of
perceived hearing values 660. Although humans hear at frequencies
ranging from 15 to 20,000 hertz (Hz), the normal hearing frequency
range 610 is narrower, extending from 250 to 12,000 Hz. During a
hearing test, an audiologist may choose to test sounds of different
frequency ranges across a series of amplitudes. Amplitude range 620
shows a typical range of 30 to 110 decibels (dB). Individual
hearing values 630 shows an example of decibel levels by frequency
that an individual may hear at 110 dB. Normal hearing values 640
shows an example of the decibel levels by frequency that the
individual should hear at 110 dB, and amplification factors 650
shows the difference between individual hearing values 630 and
normal hearing values 640 at 110 dB. As well known in the prior
art, an audiologist adjusts an individual's hearing aid by having a
digital signal processor of a hearing aid programmed using
amplification factors 650. The final perceived hearing, however,
may still be deficient, as indicated by the perceived hearing
values 660.
[0035] Referring again to FIG. 1, the volume versus pitch
measurement information, which preferably is obtained from a table
having the form of the table 600, is normalized for each of the
metrics 111 and 112 into a signal metric that is a linear scale
from lowest possible score 190 to perfect hearing score 120. The
generation of scores based on the measurement information and
consistent with the defined metrics 111 and 1 12 could be, for
example, as simple as an average of all volume and pitch scores
where perfect hearing is 100% and worst case hearing is 0%.
[0036] 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.
[0037] 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.
[0038] 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.
[0039] 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.
[0040] 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.
[0041] 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.
[0042] 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.
[0043] Referring to FIG. 1, a diagnostic score 140 for each of the
metrics 100 is generated based on the measurement information for
the associated dimension and in view of the corresponding defined
metric 100. For example, the diagnostics score 140 for each of the
metrics 100 is determined prior to the initiation of hearing
correction remedies by the audiologist who performed the respective
assessments of the dimensions of the individual. A goal score 130
is a best score that an individual can expect to obtain for a
dimension, based on hearing assistance administered through use of
a hearing aid, given the extent of physical loss inside an ear. As
described below, for some metrics, a perfect score 120 that is
different from a goal score 130 may not exist.
[0044] 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%.
[0045] 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.
[0046] 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.
[0047] Referring still to FIG. 1, for some of the metrics 100, the
goal score 130 does not exist or is the same as the diagnostic
score 140. For example, for the appearance/performance tradeoff
metric 117, the diagnostic score representative of an individual's
preference for an aesthetically pleasing instrument, despite it
only having basic functionalities, may not be likely to change in
the course of rehabilitation. Therefore, for the metric 117, there
is no goal score or the goal score 130 is the same as the
diagnostic score 140 and also the perfect score 120.
[0048] 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.
[0049] For purposes of illustration, FIG. 1 is shown with exemplary
diagnostic, goal and perfect scores for each of the metrics 100.
Referring again to FIG. 1, line 147 connects the diagnostic scores
140 for each of the metrics 100 to define a bounded area that
corresponds to a cumulative diagnostic score 145. The cumulative
diagnostic score 145, for example, can constitute the sum of the
diagnostics scores 140 for the metrics 100.
[0050] 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
FIG. 1 in illustrative manner, and that the cumulative scores 125,
135 and 145 can be generated so long as a plurality of dimensions
of an individual are assessed.
[0051] 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.
[0052] Referring again to FIG. 1, metrics 100 that affect the left
and right ears of an individual with different severity are
identified with an binaural impact indication 160. For example,
diagnostic score 140 for volume metric 111 for the left ear of an
individual can be different from diagnostic score 140 for volume
metric 111 for the right ear. Binaural impact indication 160 can be
helpful in prescribing an aural rehabilitation plan for a
particular individual, because different steps to reach goal 150
can be prescribed for each ear. For example, a rehabilitation plan
that accounts for binaural indications can include CD training with
headphones that directs sound only to one ear.
[0053] 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.
[0054] FIG. 2 illustrates a health hearing system 200 for assessing
the dimensions of the individual 105, and for generating scores for
the respective metrics 100 corresponding to the assessed dimensions
that can assist in selection of a rehabilitation plan in accordance
with the present invention. Referring to FIG. 2, the system 200
includes a hearing test unit 215 containing a test administration
computer 220. The computer 220 is coupled to a set of conventional
headphones 225, a conventional keyboard 230 and a conventional
monitor 235, and contains a series of hearing test programs 240. A
network 250 couples the computer 220 to a central hearing health
computer system 260. The central hearing health computer system 260
includes a database 263. The database 263 includes a quantity of
individual profile information 265, several individual test results
267 and several aural rehabilitation plans 269.
[0055] 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.
[0056] 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.
[0057] 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.
[0058] 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.
[0059] 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 FIGS. 3-5.
[0060] Referring again to FIG. 2, in an exemplary operation of the
health hearing system 200, individual 105 with hearing loss wears
headphones 225 and uses keyboard 230 and monitor 235 to take a
hearing test at test administration computer 220. As part of the
hearing test, the computer 220 executes the series of hearing test
programs 240 to collect profile information and assess physical
dimensions and personal environment dimensions of the individual
105 corresponding to the set of metrics 100, which include the
metrics 111-118. The profile information for the individual 105 is
stored in individual profile information 265, and scores generated
from the measurement information obtained from the hearing tests
corresponding to the respective metrics 100 are stored in
individual test results 267. Central hearing health computer system
260 then analyzes individual profile information 265 and individual
test results 267 to select one or more aural rehabilitation plans
for the individual 105. The selected plan that is prescribed to the
individual 105 is then stored in an aural rehabilitation plan
record in aural rehabilitation plans 269, where the plan is indexed
by the corresponding scores and profile information for the
respective metric 100 of the individual 105.
[0061] 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 FIGS. 3 and 4, an audiologist or
other hearing professional can later access and search aural
rehabilitation plans 269 to select an aural rehabilitation plan for
another individual with hearing loss based on matching of
individual scores for respective diagnostic metrics with scores for
the same respective metrics that index aural rehabilitation plans
stored in the database 263.
[0062] 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.
[0063] FIG. 3 illustrates a system 300 for selecting an aural
rehabilitation plan for the individual 105 by accessing information
stored in the database 263 of the system 260. Referring to FIG. 3,
the system 300 includes the central hearing health computer system
260 of the system 200, which is the same system 200 described above
in connection with FIG. 2, and an audiologist 310. Audiologist 310
is a highly trained and licensed hearing health professional, such
as a physician, and is preferably certified to prescribe a remedy,
such as an aural rehabilitation plan, for the individual 105.
[0064] 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.
[0065] Referring to FIG. 3, in a preferred process for selecting an
aural rehabilitation plan in the system 300, audiologist 310
retrieves an aural rehabilitation plan, selected in accordance with
present invention, from aural rehabilitation plans 269 and
prescribes it to the individual 105. After the plan is prescribed
to the individual 105, the audiologist can update the records in
the aural rehabilitation plans 269 of the database 263 based on
feedback received from the individual or the resulting
rehabilitative progress of the individual. For example, the
feedback can be used to define a new aural rehabilitation plan for
a metric associated with a personal environment dimension. The new
plan is included as a new record in the plans 269 for the
appropriate metric and is indexed by scores and profile information
of the individual from which the feedback was received.
Alternatively, the feedback or the progress results can be used to
annotate the aural rehabilitation plan record for the individual
which includes the prescribed plan. The feedback, for example, can
constitute a subjective component, such as the individual's
complaint that he is uncomfortable wearing a particular type of
hearing aid and, therefore, only uses the hearing aid occasionally,
rather than all of the time as would be necessary to attain the
full potential of rehabilitation available through use of the
hearing aid. In addition, the feedback can include an objective
component, such as the individual finds it difficult to initially
use a particular hearing aid but has been using it and
rehabilitation progress has been as expected.
[0066] FIG. 4 is a preferred high level method 400 for assessing
physical and personal environment dimensions of the individual 105,
quantifying the measurement information obtained from assessment of
each of the dimensions to define respective metrics from which
diagnostic scores and goal scores can be generated, and using
profile information and individual scores for at least one of the
physical dimensions and personal environment dimensions of the
individual 105 to select an aural rehabilitation plan from the
plans contained in the aural rehabilitation plan records stored in
plans 269. For purposes of illustration, the process 400 is
described in connection with the operations that would be performed
using the system 200 and system 300.
[0067] Referring to FIG. 4, in step 410, the audiologist 310, using
the programs 240, assesses the individual 105 to obtain measurement
information for all of the metrics 100. For example, an assessment
of the personal environment dimension of speech intelligibility,
which corresponds to the metric 113, can be performed in accordance
with a diagnostic testing method of creating a training product
customized for an individual that determines specific, troublesome
words and sentences based on the individual's hearing profile, and
stores the measurement information obtained from such testing in a
database. See "SYSTEM FOR AND METHOD OF TRAINING A USER TO
UNDERSTAND HUMAN SPEECH CORRECTLY WITH A HEARING AID DEVICE", U.S.
Provisional Application Ser. No. 60/482,159, filed Jun. 24, 2003,
assigned to the assignee of this application and incorporated by
reference herein. Further in step 410, the basic profile
information for the individual 105 is also collected and stored in
individual profile information 265.
[0068] 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 FIG. 1. In a preferred
embodiment, the assessments in step 410 provide measurement
information for defining volume metric 111, pitch metric 112,
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. The quantification of the measurement
information that is performed to define a metric preferably
includes normalizing the measurement information obtained from the
assessment of each dimension into a signal metric that is a linear
scale from lowest possible score 190 to a perfect score 120. The
generation of a diagnostic score for a corresponding metric, such
as the metric 112, can be performed by simply summing all scores
where a perfect hearing score is 100% and a worst case hearing is
0%. In addition, in step 415, the audiologist 310 optionally uses
the measurement information corresponding to a metric to define a
goal metric score 150.
[0069] 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.
[0070] 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 FIG. 5. The tables 500 are stored in the database 263,
preferably in the aural rehabilitation plans 269, and represent the
aural rehabilitation plans previously prescribed to patients
indexed by profile information and scores corresponding to the
respective diagnostic metrics of the patients to whom the plans
were prescribed. The tables 500 further can include aural
rehabilitation plans, with associated indexing information,
generated by performing conventional interpolation processes using
information representative of the previously prescribed aural
rehabilitation plans and their associated indexing data. The tables
500 are evaluated to select an aural rehabilitation plan for the
individual 105, in view of the diagnostic and goal scores and
profiles of the individual for corresponding respective personal
environment and physical dimensions. Referring to FIG. 5, the table
500 includes a set of diagnostic metrics 510, which correspond to
the assessed physical and personal environment dimensions; a set of
user profiles 520 containing information preferably obtained during
the assessments; a set of diagnostic metric scores 530; a set of
goal metric scores 540; a rehabilitation trajectory 550; and a
rehabilitation plan 560.
[0071] 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 FIG. 5, user profiles 520 are the profiles of the patient
with hearing loss for each diagnostic metric 510. Diagnostic metric
scores 530 are the patient's hearing test scores for each
diagnostic metric 510. Goal metric scores 540 are the best scores
that the individual can expect to achieve for each diagnostic
metric 510 after hearing assistance, such as application of a
hearing aid instrument, given the extent of physical loss inside
the ear. Rehabilitation trajectory 550 is the step-by-step progress
for the individual to proceed from diagnostic metric scores 530 to
goal metric scores 540 for each diagnostic metric 510.
Rehabilitation trajectory 550 further includes WK1, WK2, and WKN,
which represent the progressive improvement of the patient for each
diagnostic metric 510 on a weekly basis from the first week to the
Nth week, where N varies and is the number of total weeks for
rehabilitation prescribed to the patient by audiologist 310.
Rehabilitation plan 560 is the plan previously prescribed to the
patient to restore hearing and progress from diagnostic metric
scores 530 to goal metric scores 540 along rehabilitation
trajectory 550.
[0072] 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 FIG. 3,
for the individual 105, central hearing health computer system 260
determines rehabilitation trajectory 550 and rehabilitation plan
560 by comparing individual profile information 265, individual
diagnostic scores 140 and individual goal scores 130 with the
information used to index previously prescribed rehabilitation
plans, namely, profiles and scores corresponding to respective
diagnostic metrics, contained in aural rehabilitation plans 269.
Based on the comparison, the system 260 retrieves at least one copy
of a table 500 having profiles 520, diagnostic metric scores 530
and goal metric scores 540 corresponding to one or more of the
diagnostics metrics 510 that match with individual profile
information 265, individual diagnostic scores 140 and individual
goal scores 130 for the individual 105 associated with respectively
corresponding metrics. At this point, assuming that only a single
table is selected, central hearing health computer system 260 has
selected a rehabilitation trajectory 550 and a rehabilitation plan
560 for the individual 105, which is represented in the matching
copy of table 500. The process of matching user profiles and scores
from tables within a database is well known in the art, and any
known technique, such as, for example, described in U.S. Pat. No.
6,063,028, "Automated Treatment Selection Method," incorporated by
reference herein, can be applied in the subject invention.
[0073] 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.
[0074] 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.
[0075] 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.
[0076] 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.
[0077] 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.
[0078] 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.
[0079] 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.
[0080] 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.
[0081] 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.
[0082] 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.
[0083] 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.
* * * * *