Multimedia feature for diagnostic instrumentation

A system and method for obtaining hearing ability related data from a subject outputs tones or sounds and monitors the subject's responses to the tones or sounds. An error condition is detected based on the responses, and corrective instructions are automatically delivered based on the error condition detected. The hearing evaluation is resumed by outputting tones or sounds, and the steps of outputting, monitoring, detecting, automatically delivering and resuming are iterated until evaluation of the subject's hearing has been completed.

BACKGROUND OF THE INVENTION

The present invention relates to a multimedia interface of a diagnostic test instrument and, more particularly, to automated testing, including multimedia-derived instructions, test monitoring, and error response, by an audiometer or other medical or diagnostic test instrument.

A wide variety of medical and diagnostic test instrumentation is known. An example of such instrumentation is an audiometer. The audiometer is an electrically activated generator of test tones for evaluation of hearing. Other medical and diagnostic instrumentations include a spirometer for measuring lung capacity, vision testing equipment, blood alcohol testing equipment, and occupational health industry maintenance testing equipment, such as blood pressure, EKG, and other wellness testing equipment. Generally, these and other prior testing instrumentations require one or more individuals to administer the test by operating the equipment and giving instructions to the test subject.

The trend in testing, however, appears to be toward automation. Through automation, reduced numbers of test administrators may be required and increased accuracy of testing, with lack of deviation caused by human administrator error, may be possible. Although certain limited automation has previously been possible, that automation has been directed primarily to the automated compilation, organization, and reporting of data in desirable formats. Processing units, such as, for example, personal computers, have previously been employed to achieve the automation of the compilation, organization, and reporting functions. Little automation, if any, has previously been achieved, however, in connection with the actual administration of the test. Administration of such tests has typically been performed almost wholly by one or more human test administrators.

Hearing testing has for several decades been performed utilizing an instrument called an audiometer. Prior to the audiometer, tuning forks and other tone generating devices were employed. In the early testing, a test subject responded directly to a test administrator who recorded test results based on the administrator's subjective determinations. The advent of the audiometer, an electronic instrument that generates tones, provided a degree of standardization in hearing testing because uniform tones and proper calibrations are better achieved.

Even after the invention of the audiometer, however, hearing testing was far from standardized, as testing varied in both procedures and determinations. A standardized procedure, still followed today, was then developed for hearing testing. That procedure is referred to as the “Hughson-Westlake” procedure. Other procedures are followed in some instances, but the Hughson-Westlake procedure is probably the most common.

In the Hughson-Westlake procedure, tones at a level audible to the test subject, such as, for example, 30 dB, are first presented to the subject. The test subject responds that the tones are heard, and then the level of the tones are reduced by 10 dB. This is repeated with the test subject responding that the tones are heard followed by 10 dB reductions until the test subject's response (or lack of response) indicates that the tones are not heard. When the test subject so responds that the tones are not heard, the tone level is raised 5 dB. If the test subject does not then respond, the level is raised another 5 dB, and this is repeated until the test subject signals that the tone is heard. This entire process is repeated until the test subject has three ascending positive responses at the same level. In order to make comparison of hearing quality over time, a first test is administered to establish a base line hearing level and later testing, undertaken at subsequent time intervals, provides results for comparison to base line. The comparison indicates any hearing loss or other changes over time.

As with diagnostic and industrial health testing instruments, generally, audiometers have progressed towards more automation. Also as with other instruments, however, automation of audiometers has typically focused on compilation, organization, and reporting of test results. The automation has not been directed to replacement of a human test administrator (or at least the traditional functions of such an administrator) by a machine automated process.

As previously mentioned, automation, particularly by a machine such as a computer, achieves certain advantages. In particular, the testing may be more uniform among subjects and test periods, whereas testing is subject to variation when a human test administrator administers and grades the test. Also, supplying human test administrators to conduct tests is rather costly. Reducing the required number of test administrators through further automation of testing procedures may reduce or eliminate those costs. Furthermore, test presentation and determined results may vary among human test administrators. More standardized and accurate testing may be possible if intervention of a human test administrator is reduced through further automation. In addition to those advantages, certain automation may provide added advantages, for example, multi-lingual test administration, multiple simultaneous different tests, multiple simultaneous test subjects, visual features, and other possibilities.

Embodiments of the present invention provide advantages of multimedia automation in diagnostic testing employing electronic or other instrumentation. The embodiments are particularly suited in the case of an audiometer, however, numerous other applications of the embodiments are possible. The above-described advantages, as well as other advantages, are achieved through the embodiments. The present invention is, thus, a significant improvement in the art and technology.

SUMMARY OF THE INVENTION

An embodiment of the invention is a method for automatedly administering an audiometric test. The method comprises the steps of controlling an audiometer to selectively switch the audiometer output between test tones generated by the audiometer and sound signals generated from digital information, first switching the audiometer output to sound signals when the step of controlling indicates a beginning of a new test, a completion of a current test, or a test error, outputting sound representative of the sound signals after the step of first switching, second switching the audiometer output to test tones after the step of outputting, and outputting test tones until the next step of first switching.

Another embodiment of the invention is a multimedia audiometer. The multimedia audiometer comprises means for outputting sound signals generated from digital information, means for outputting test tones, means for switching between the means for outputting sound signals and the means for outputting test tones, and means for controlling the means for switching, the means for controlling being communicatingly connected with the means for switching. The means for switching is communicatingly connected with the means for outputting sound signals and the means for outputting test tones.

Yet another embodiment of the invention is a multimedia audiometer. The multimedia audiometer comprises a computer, a tone generator, and a switch connected with the computer and the tone generator. The switch selectively causes either the tone generator or the computer to output sound waves, and the computer controls the switch.

Another embodiment of the invention is an audiometer. The audiometer comprises a processor, a memory, communicatingly connected with the processor, for storing digital data, a sound wave generator, for generating analog sound signals in respect of digital data, electrically connected with the processor, a test tone generator electrically connected with the processor, and a switch connected with the sound wave generator, the test tone generator, and the processor. The switch is controlled by the processor to selectively cause either the sound wave generator or the test tone generator to output sound waves.

A further embodiment of the invention is an instrument that conducts a test protocol on a test subject. The test protocol comprises an output by the instrument followed by an input to the instrument. The test subject determines the input, which input may be positive, negative, or null. The instrument comprises an output generator, an input detector for detecting the input, a digital data storage for storing a digital data, a multimedia converter, the multimedia converter converts the digital data to an analog signal, and logic circuitry connected to the input detector, the digital data storage, the multimedia converter, and the output generator, for logically operating on the input, reading the digital data, delivering the digital data to the multimedia converter, and controlling the output generator.

Yet another embodiment of the invention is a multimedia audiometer. The multimedia audiometer comprises a basic audiometer, a computer, a multimedia input interface communicatingly connecting the computer and the basic audiometer, and a communications interface communicatingly connecting the computer and the basic audiometer.

Another embodiment of the invention is a diagnostic instrument. The diagnostic instrument comprises means for outputting an audible sound, means for generating a test tone, means for storing a digital data, means for generating an analog signal derived from the digital data, means for switching an output of the means for outputting between the test tone and the analog signal, the means for switching being electrically connected to the means for generating a test tone and the means for generating an analog signal, means for processing, means for inputting, the means for inputting connects the means for processing to the means for outputting, and the means for communicating, the means for communicating connects the means for processing to the means for outputting, the means for generating the test tone, the means for storing the digital data, the means for generating the analog signal, the means for switching, and the means for inputting.

Yet another embodiment of the invention is a method of performing a diagnostic test protocol. The method comprises the steps of outputting an audible sound, generating a test tone, storing a digital data, generating an analog sound derived from the digital data, switching the audible sound from the step of outputting between the test tone and the analog signal, processing the digital data, and controlling the steps of outputting, generating the test tone, storing, generating the analog sound, and switching.

DETAILED DESCRIPTION

Referring toFIG. 1, a functional block diagram of a conventional audiometer2may be described. Although the following discussion primarily addresses embodiments of the present invention employed for an audiometer, the embodiments have varied application in a wide variety of medical and diagnostic instrumentation. All those applications are intended as included within the scope of the invention. Also, the following describes various embodiments of the present invention as particularly employed with the conventional audiometer2. It is to be understood that the conventional audiometer2is detailed only for example purposes, and all other alternative audiometer configurations, as well as other instrumentation and configurations thereof, are also applications for the invention in accordance with the principles herein.

Conventional Audiometer

The conventional audiometer2is generally comprised of three parts: microprocessor circuitry4, audio circuitry6, and certain optional elements8. In addition to those three parts, the conventional audiometer2includes a power supply and related elements not shown in the functional block diagram. One example of the conventional audiometer2is the RA250 Microprocessor Audiometer available from TREMETRICS, Inc., Austin, Tex. Of course, as previously mentioned, the conventional audiometer2illustrated is shown only for purposes of illustration and example. Other audiometers and other types of medical and diagnostic instrumentation are also within the scope of the invention.

Microprocessor Circuitry

The microprocessor circuitry4of the conventional audiometer2may include a processing unit (CPU)12, such as, for example, an Intel™ 8085 microprocessor or another microprocessor. The CPU12serves to coordinate and control operations and functions of the conventional audiometer2. The CPU12conductively connects with various memory, such as, for example, erasable programmable read only memory (EPROM)14and random access memory (RAM)16. The memory14,16may serve to store a software protocol which controls the CPU12to cause the conventional audiometer2to provide audiometric functions. The memory14,16may also serve to maintain certain variables to achieve desired operations and calibration of the conventional audiometer2, or simply to provide storage for values made available to and from the CPU12.

In addition to the memory14,16, the CPU12conductively connects with various input and output ports and peripherals. Input and output ports may include a serial I/O port22and a parallel interface24. The serial I/O port22may provide connections for certain optimal elements8, as hereinafter discussed. The parallel interface24may connect with an input device, for example, a keyboard20. The parallel interface24may also connect with the audio circuitry6, as later explained. Another input device, such as a display18, for example, may connect with the memory14,16, CPU12, and other features of the microprocessor circuitry4. Such other features of the microprocessor circuitry4may include, for example, certain programmable registers26and other elements.

Audio Circuitry

Now discussing the audio circuitry6of the conventional audiometer2, the audio circuitry6interfaces with the microprocessor circuitry4in several ways. The programmable registers26may serve as ports that connect with an oscillator (also “frequency generator”)30. The oscillator30may provide timing for a sine wave generator32that produces a digitally synthesized sine wave from which audible test tones are derived. Because the sine wave generator32produces a digitally synthesized wave, the wave may be smoothed by a low pass filter34.

The low pass filter34may connectively interface with the parallel interface24of the microprocessor circuitry4. Other elements of the audio circuitry6, such as frequency selector36, an electronic attenuator38, a pulse control40, a relay control attenuator42, and a handswitch jack44, may conductively connect with the parallel interface24to complete the interface of the audio circuitry6with the microprocessor circuitry4of the conventional audiometer. Pursuant to this interface arrangement, the audio circuitry6and the microprocessor circuitry4may communicate signals for control and other purposes.

In addition to the connection of the low pass filter34with the parallel interface24, the low pass filter34may conductively connect with frequency compensation circuitry, such as, for example, a frequency selector36that, together with the control provided through the parallel interface24, helps compensate for attenuation. Other elements, such as the electronic attenuator38which connects with the frequency selector36, also provide compensation for attenuation. The sine wine generator32feeds the pulse control40which, together with input to the pulse control40from the electronic attenuator38, delivers signals representative of desired test tones to a power amplifier46. The power amplifier46feeds the relay control attenuator42for left and right earphone signals. The relay control attenuator42is conductively connected with an earphone jack48.

In order to allow a test subject to interface with the audio circuitry6, earphone speakers50and a handswitch52may be provided. The earphone speakers50may plug into the earphone jack48. The test subject wearing the earphone speakers50will then receive test tones generated by the conventional audiometer2. The handswitch52may plug into the handswitch jack44. The handswitch52provides means for the test subject to interface with the conventional audiometer2in order to signal to the conventional audiometer2that the test subject either does or does not correctly receive test tones through the earphone speakers50.

Options

In addition to the basic elements just described, the conventional audiometer2may include certain optional elements8. Various optional elements8are possible, depending upon desired operations and functions. Two common optional elements8of the conventional audiometer2have been an RS232 port8aand a talkover card8b.The RS232 port8amay conductively connect to the serial I/O port22to allow communications of the microprocessor circuitry4with external peripherals (not shown) connected with the RS232 port8a.Examples of external peripherals which may connect to the RS232 port8amay include printers, terminals, and modems. The RS232 standard and suitable connections to ports conforming thereto are generally known.

The other of the common optional elements8, the talkover card8b,is of particular significance in embodiments of the present invention. The talkover card8bis conductively connected with the audio circuitry6of the conventional audiometer2between the relay control attenuator42and the earphone jack48. In effect, the talkover card8bserves as a switch to divert input to the earphone jack48when desired by a human test administrator (not shown). The human test administrator may selectively “throw” the switch and cause the input to the earphone jack48to switch from signals from the relay control attenuator42representative of test tones to signals representative of the human test administrator's instructions then being voiced. Details of the talkover card8bare hereinafter more fully discussed with respect toFIG. 3.

Referring now toFIG. 2, a detailed schematic of the conventional audiometer2ofFIG. 1is shown. Those skilled in the art will understand and appreciate the electrical elements and connectivities of the detailed schematic.

Referring now toFIG. 3, a detailed schematic is provided of the talkover card8bof the conventional audiometer2. The talkover card8bcomprises a fixed gain operational amplifier60. A voice microphone62is an input to the amplifier60. Other common electronic elements, such as, for example, resistors, capacitors, and others, may be included in the circuitry of the talkover card8b.The amplifier60is connected to the input to the earphone jack48of the audio circuitry6of the conventional audiometer2(shown inFIG. 1) by a relay64a.When a human test administrator wishes to deliver voice sounds, rather than test tones, to a test subject wearing the earphone speakers50plugged into the earphone jack48(shown inFIG. 1), the test administrator causes the relay64ato be thrown. The test administrator, by such action, simultaneously causes the conventional audiometer2to interrupt the test then in progress, discontinuing test tone generation.

Referring toFIGS. 1–3, in conjunction, the relay64awhen so thrown connects the amplifier60, across switches66a,to the input to the earphone jack48. In particular, electrical connector68passes the voice signals from the amplifier60to the earphone jack48for delivery through the right ear speaker of the earphone speakers50and electrical connector70similarly passes the voice signals to the left ear speaker. When relay64aresults in closure of its switches66a,relay64bresults in opening of its switches66b,and vice versa. In this manner, either voice signals through the talkover card8bor test tone signals through the audio circuitry6at any instant, but not both simultaneously, is delivered through the earphone speakers50. As those skilled in the art will understand and appreciate, this design of the conventional audiometer2has allowed a human test administrator to interrupt test tone testing to give instructions, error messages, and other voice commands. The conventional audiometer2has required intervention of a human test administrator, however, by selectively throwing relays64a,band speaking into microphone62of the talkover card8b,in order to conduct hearing test with intermittent instructions and messages.

Multimedia Embodiments

Referring now toFIG. 4, a multimedia audiometer100, according to embodiments of the present invention, may be described. The multimedia audiometer100includes a basic audiometer200having the basic elements of the conventional audiometer2(shown inFIG. 1). That is, the multimedia audiometer100is also comprised of the microprocessor circuitry4and the audio circuitry6(or other similar processing and audio electronics and circuits) of the conventional audiometer2(shown inFIG. 1). The earphone speakers50and the handswitch52are also interfaced with the basic audiometer200.

Although the multimedia audiometer100and the conventional audiometer2share these similar basic elements, the basic audiometer200is merely a subset of the entire multimedia audiometer100, as is apparent inFIG. 4. In addition to the elements of the basic audiometer200,2, the multimedia audiometer100includes a computer102, such as a personal computer, another type of computer, or some other processing and storage device. The computer102may be equipped and connected with peripherals, such as a keyboard106and a display monitor104, as well other known input/output, communications, printing, and peripheral equipment. In any event, the computer102should have multimedia capabilities, that is, the computer102should be capable of producing sound waves and/or visual images from representative digital information stored, generated, and/or manipulated within or by the computer102.

The computer102may be conductively connected with the basic audiometer200through two interfaces: a communications interface108and a multimedia input interface110. The communications interface108may allow for serial, parallel, or other communications. If communications are serial, the communications interface108may connect the computer102with the RS232 port8a(shown inFIG. 1) in standard manner, as though the basic audiometer200is peripheral to the computer102. The multimedia input interface110requires, however, that the conventional audiometer2be modified in certain respects to provide the basic audiometer200for multimedia automation of testing, as hereafter described.

Referring now toFIG. 5, the communications interface108and the multimedia input interface110connect the computer102with the basic audiometer200to form the multimedia audiometer100, as shown in functional block form. A serial input/output port (not shown in detail) of the computer102may directly connect via the communications interface108with RS232 port8aof the basic audiometer200. A multimedia output port (not shown in detail) of the computer102may directly connect via the multimedia input interface110with a multimedia talkover card118b,similar to the talkover cord8b(shown inFIG. 3) of the conventional audiometer2. The multimedia output port of the computer102may, for example, be a port of a sound card (not shown in detail) from which sound signals are output by the computer102. Alternatively or additionally, other multimedia outputs (not shown) of the computer102, for example, graphical image or video outputs, may connect with the multimedia input interface110in similar manner. The talkover card8b(shown inFIG. 3) of the conventional audiometer2configuration has not previously provided a port for connection of the multimedia input interface110. The conventional audiometer2may, therefore, be adapted to provide such port. The adapted conventional audiometer2is the basic audiometer200.

Referring now toFIG. 6, a sound port120of a multimedia talkover card118bfor multimedia input to the basic audiometer200may be described. The sound port120connects with the multimedia input interface110, so that multimedia outputs of the computer2are input to the multimedia talkover card118b.The sound port120may include a connector120ato which the multimedia input interface110may be plugged. The connector120amay be attached with two input leads120b.The input leads120a,bmay be attached with an audio jack plug121. The audio jack plug121is insertable in an audio jack122connected to the amplifier60output. When the audio jack plug121not is inserted in the audio jack122, the output of amplifier60is shorted prior to the switches66a.When the audio jack plug121is inserted in the audio jack122, however, the circuit is completed and the computer102connected to the sound port120may supply multimedia input to the switches66a.In effect, the microphone62is substituted with the multimedia input via the sound port120. All other features of the multimedia talkover card118bare substantially the same as the features of the talkover card8bof the prior technology.

Although the input leads120bof the sound port120are shown as connected with an output of the amplifier60in Figure, alternatively, the input leads120bcould in similar manner connect with inputs to the amplifier60or at some other location prior to or after the amplifier60. Furthermore, although the multimedia talkover card118bis expressly described as a “card” to the basic audiometer200, it is to be understood that any other functional elements and circuitry that perform similarly, such as, for example, a relay circuit that switches between the tone generator of the basic audiometer200and the multimedia output from the computer102, as well as other possibilities, are all within the scope of the invention.

Now referring toFIG. 7, in conjunction withFIGS. 4–6, operations300of the multimedia audiometer100and the software driving those operations300are discussed. When power is supplied to the multimedia audiometer100, the basic audiometer200, as well as the computer102, may perform various set-up functions302. Those set-up functions302of the multimedia audiometer100, for example, boot-up and initialization of the computer102and start-up and initialization of the basic audiometer200, are conventional. The start-up and initialization of the basic audiometer200may be substantially the same as that of the conventional audiometer2(shown inFIG. 1).

Generally, this start-up and initialization of the basic audiometer200may proceed, for example, as follows:At turn-on, the basic audiometer200presents a first tone and a message appears on the display18. The basic audiometer200is now ready for operation. If a processing error by the CPU12is discovered during the turn-on, an appropriate message is displayed.The following example illustrates an initialization procedure for the basic audiometer200. Keys of the keyboard20are indicated by [ ] and messages in quotes. To begin, press:

SPECIALFUNCTION00Initialization of audiometer01Enter date and time02Mode Pulsed/Continuous03Enter Examiner ID04Invent runtable to test better ear first05Select Printer Format06Select or Delete 8K07Select Baud rate08Turn-on or off audio feedback for key pushes09Accelerated listening check10Check calibration date11Call Ram Rock check12Calibration mode and program calibrationeeprom13Printer Text14Not used15Display routine for time and date (no entry)16Not used17Display selected audiogram18Print selected audiogram or audiograms19Display and/or enter serial number20Not used

Software protocols to accomplish the start-up and initialization of the basic audiometer200may be stored in the memory14,16of the basic audiometer200or elsewhere. Processing and control for the start-up and initialization of the set-up functions302are performed by the CPU12of the basic audiometer200. Alternatively, the basic audiometer200could be controlled by the computer102to perform the start-up and initialization, or start-up and initialization could be controlled manually or in some other manner.

After the set-up functions302, including start-up and initialization of the basic audiometer200, are completed, the basic audiometer200may be ready to begin administering a new audiometric test of a test subject. A new test may be begun, for example, by pressing a key of the basic audiometer200or, alternatively, by a similar input to the computer102. Upon the start of the new test, the computer102may control the basic audiometer200by communications over the communications interface108(shown inFIGS. 4–5).

If initial instructions to the test subject are desired, the computer102may control304the basic audiometer200over the communications interface108(shown inFIGS. 4–5). This control304may trigger the relay64aand the relays64b(shown inFIG. 2) to close the switches66aand open the switches66b(shown inFIG. 2), respectively. When the switches66aare closed and the switches66bare opened in this manner, sound signals passed to the sound port120from the computer102over the multimedia input interface110are delivered through the amplifier69of the multimedia talkover card118band through the earphone jack48to the earphone speakers50.

The particular sound signals so passed to the earphone speakers50may be derived from digital information stored or generated in, or read by, the computer102. The computer102may select and output306signals representative of the particular digital information. If the testing is just beginning, the signals so selected and output306may be initial instructions to the test subject about the test and the testing procedure. Of course, the particular signals could be representative of virtually any type of information which is subject to derivation from digital data. Although sound is described here as being derived from digital data, those skilled in the art will know and appreciate that digital data may be manipulated and processed in a multitude of ways to derive other types of information, for example, visual graphics and images and others.

After the computer has selected and output306the desired sound signals to the basic audiometer200and signals have been delivered to the test subject as sound waves through the earphone speakers50, the computer102, again may control308the basic audiometer200. The control308at this instant may trigger the relay64ato close the switches66aand the relays66b(shown inFIG. 2) to open the switches66b,respectively. The control308, then, causes the basic audiometer200to generate310a series of test tones, such as, for example, tones in accordance with the Hughson-Westlake procedure or another testing protocol.

When the switches66aare closed and the switches66bare opened because of the control308, the test tones generated310by the audio circuitry6of the basic audiometer200are delivered through the earphone jack48to the earphone speakers50. According to the particular testing protocol, the test subject may respond to the test tones by input312via the handswitch52connected to the basic audiometer200. The basic audiometer200, in cooperation with the computer102, will detect and determine any error314of the input312response.

If there is not any error316, then the basic audiometer200may continue to generate successive test tones320according to the particular test protocol, until the test is completed322. The successive test tones320are generated in the same manner as previously described. That is, the basic audiometer200operates to generate test tones310delivered to the test subject; the test subject responds with input312via the handswitch52; and the audiometer200, in conjunction with the computer102, detects and determines314any error.

If an error318is detected and determined314, the computer102, based on its particular programmed logic, determines324whether to proceed326with the testing, to re-test328, or to perform some other function (not shown). Certain errors that may be encountered during the administration of the test include, for example, the following:No response at 1 kHz, Error Code E1, signifies that the test subject is not responding to the test tone. The test subject may receive a multimedia sound message, generated by the computer102and passed through the earphone speakers50, as to how to take the test, for example, as follows:“There has been no response for any tone in the initial test—as soon as you hear a tone cut it off by pressing and releasing the hand switch.”Then, the test may be restarted.Failed to Establish Threshold, Error Code E2, signifies that the basic audiometer200is unable to establish a hearing threshold level (HTL) from the response of the test subject. The test subject may be instructed based on digital data of the computer102, for example, as follows:“The audiometer has been unable to establish a threshold—listen for the tone and as soon as you hear the tone cut it off by pressing and releasing the hand switch.”The test may then recommence.Hand Switch Error, Error Code E4, signifies that the test subject is not releasing the response handswitch52. The test subject may, for example, receive the following instructions generated from the digital data stored by computer102:“The audiometer is recognizing the hand switch as being on for a length of time—as soon as you hear a tone cut it off by pressing and releasing the hand switch.”The test may then recommence.

Response no tone, Error Code E5, signifies that the test subject hasresponded at least three times when no tone or stimulus was present. A multimedia message, for example, as follows, may be delivered through the earphone speakers50:“The audiometer is recognizing responses when no tone is present—as soon as you hear a tone cut it off by pressing and releasing the hand switch.”The test is, thereafter, restarted.The foregoing error codes, multimedia messages, and operations are merely example possibilities. An example of an entire error code list is as follows:

In the case that a re-test328is warranted because of an error or otherwise, the operations300begin anew with the computer control304of the basic audiometer200over the communications interface108(shown inFIGS. 4–5) to trigger the relays64a,b.The testing thereafter proceeds through the steps of selections and output306, computer control308, test tone generation310, test subject response input312, and detection and error determination314.

Once the entire test protocol is completed in the foregoing manner, the test is completed322. The computer102may then control330the basic audiometer200to trigger the relays64a,bto close the switches66aand to open the switches66b.The control330is accomplished in the manners previously described by communications between the computer102and the basic audiometer200over the communications interface108.

After the control330so sets the switches66a,b,the computer102may further select and output340sound signals, which sound signals are derived from digital data stored, generated or read by the computer102. The sound signals may travel to the earphone jack48and the earphone speakers50to deliver final instructions and messages to the test subject.

Numerous alternatives and variations are possible for the multimedia audiometer100. For example, digital data stored, generated or read by the computer102may be representative of a wide variety of sounds, images, video, or other multimedia features. In certain embodiments, the particular digital data may allow the test subject to select any of a number of different languages through which testing is administered. Further, digital data may be manipulated by the computer102in such a manner that multiple simultaneous tests may be administered. There are, of course, numerous other possibilities.

There are also many possible variations and alternatives in the configuration of the computer102and the basic audiometer200by providing the audiometer with additional memory, processing, wave sound generation, and appropriate software. Alternatively, the computer102could include a test tone generation means and appropriate software programming to perform the functions of the basic audiometer200. Even further, the multimedia audiometer100could be implemented by using a programmable digital tape player or compact disc (CD) player and allowing the basic audiometer200to select desired tracks to play. Other alternatives may be possible, it being understood that those skilled in the art will generally know and appreciate that the employment of computer or other control of instrumentation operations during test administration and the use of multimedia features for instruction, messages, and other herebefore required human administrative actions is possible with the incorporation of digital data, according to the embodiments of the present invention, from which are derived multimedia features.

It is to be understood that multiple variations, changes and modifications are possible in the aforementioned embodiments of the invention. Although illustrative embodiments of the invention have been shown and described, a wide range of modification, change, and substitution is contemplated in the foregoing disclosure and, in some instances, some features of the present invention may be employed without a corresponding use of the other features. Accordingly, it is appropriate that the foregoing description be construed broadly and understood as being given by way of illustration and example only, the spirit and scope of the invention being limited only by the appended claims.