Patent Description:
The types of medical devices and the ranges of functions performed thereby have increased over the years. For example, many medical devices, sometimes referred to as "implantable medical devices", now often include one or more instruments, apparatus, sensors, processors, controllers or other functional mechanical or electrical components that are permanently or temporarily implanted in a recipient. These functional devices are typically used to diagnose, prevent, monitor, treat, or manage a disease/injury or symptom thereof, or to investigate, replace or modify the anatomy or a physiological process. Many of these functional devices utilize power and/or data received from external devices that are part of, or operate in conjunction with, implantable components.

<CIT> discloses a system comprising an auditory prosthesis.

In a non-claimed example, there is a method comprising: after an initial clinical fitting of a sensory prosthesis to a recipient, performing automated fitting of the sensory prosthesis to the recipient; logging the automated fitting in a log; analyzing the log to determine fitting progress; determining that the fitting progress indicates lack of progress; and responsive to determining that the fitting progress indicates lack of progress, generating a clinician event.

In another example, there is a system comprising: an auditory prosthesis configured to provide stimulation to a recipient to cause auditory percepts based on a current map; and one or more processors configured to: receive an indication from the recipient regarding a quality of stimulation; modify the current map based on the quality of stimulation; determining a difference between the modified current map and a target map; and responsive the difference failing to satisfy a threshold, generate a clinician event.

In an example, there is a computer-readable medium having instructions stored thereon that, when executed by one or more processors cause the one or more processors to: after an initial clinical fitting of a sensory prosthesis to a recipient, perform automated fitting of the sensory prosthesis to the recipient, wherein to perform the automated fitting includes to: query the recipient regarding stimulation provided by the sensory prosthesis; receive a response to the querying from the recipient; and modifying a map of the sensory prosthesis based on the received response; determine fitting progress of the automated fitting; and responsive determining that the fitting progress indicates a lack of progress, generate a clinician event.

The same number represents the same element or same type of element in all drawings.

Current sensory prosthesis fitting is driven by clinicians measuring threshold and comfort levels at every fitting session. After initial fitting of a prosthesis, levels tend to be unstable and recipients have difficulty identifying what they perceive (e.g., audibly or visually perceive). Thus, resources spent (e.g., clinical resources) measuring levels in the first session can be potentially inefficiently spent. By contrast, resources can be conserved by having the first fitting session be conducted to arrive at a map that gives comfortable sensing at a reasonable (though not perfect) level of intensity.

In an example, the initial or subsequent fitting is based on a set of maps (e.g., operating parameters for the sensory prosthesis) extracted from data analysis. The set of maps can fit typical evolution of map increases. In the first session one of these maps is transferred to the sensory prosthesis (e.g., without any measurements). Then, during the first two weeks of use, a sensory prosthesis application slowly and automatically increases the loudness of the map (e.g., increasing to different map profiles based on the data analysis). Increases are based on interventions at regular intervals (e.g. daily) and take into account: logs of use, trajectory compared to typical or expected trajectory, and answers of the user to questions posed by the sensory prosthesis application. In some examples, formal testing is also used. In addition to the automated fitting, the recipient (or a caregiver thereof) can instigate a map change when the map is too soft or the recipient experiences uncomfortable stimulation. The clinician can follow recipient progress during the fitting process via a cloud-based data sharing system. The sensory prosthesis can also automatically indicate problems (for instance the user never accepts a map change) and flag them to the clinician. Other problems (e.g., fitting not progressing as well as expected) can be used to trigger an alert to schedule a session with a clinician. Further, because of variations how recipients progress, the scheduling of a session can be customized based on actual progress during automated fitting rather than future prediction.

Thus, in some examples, the first fitting session is quick and easy, such as by including no measurements. Then, when the recipient comes back for the next clinical session they have a stable map and sensing experience, so subsequent fitting will be more efficient to optimize the map. The technology can be configured to recognize the range of variability among individuals, which applies even within groups who share a similar demography and/or perceiving history. Moreover, there are variations among an individual's ability to reliably self-report on their sensory precepts. The clinic management thus have a greater degree of confidence that the recipient can be given a cost-effective benefit from a clinical consultation.

<FIG> illustrates an example sensory prosthesis fitting system <NUM> that includes a sensory prosthesis <NUM> that can benefit from the use of technologies described herein. The system <NUM> further includes a recipient computing device <NUM>, a clinician computing device <NUM>, and a fitting server <NUM>, which are connected over a network <NUM>. The network <NUM> is a computer network, such as the Internet, which facilitates the communication of data among computing devices connected to the computer network.

As illustrated, the sensory prosthesis <NUM> and the recipient computing device <NUM> are operated by the recipient in an environment <NUM>. The environment <NUM> defines the conditions in which the sensory prosthesis <NUM> and the recipient computing device <NUM> operate. In many examples herein, the environment <NUM> includes the auditory conditions in which the sensory prosthesis <NUM> functions. Such auditory conditions can include, for example, a loudness of noise in the environment (e.g., whether the environment <NUM> is loud or quiet). Other examples relate to the visual environment in which the sensory prosthesis <NUM> functions. Such visual conditions can include, for example, brightness or colors of the environment.

The sensory prosthesis <NUM> is a medical apparatus relating to a recipient's sensory system. For example, where the sensory prosthesis <NUM> is an auditory prosthesis, the sensory prosthesis <NUM> can be configured to provide stimulation to a recipient to cause auditory percepts based on a current map <NUM> and audio detected in the environment <NUM>. Where the sensory prosthesis is a visual prosthesis, the sensory prosthesis <NUM> can be configured to provide stimulation to a recipient to cause visual percepts based on a current map <NUM> and light detected in the environment <NUM>.

In an example, the sensory prosthesis <NUM> is an auditory prosthesis, such as a cochlear implant, bone conduction device (e.g., percutaneous bone conduction device, transcutaneous bone conduction device, active bone conduction device, and passive bone conduction device), or a middle ear stimulator, among others. The sensory prosthesis <NUM> can take any of a variety of forms and examples are such forms are described in more detail in <FIG> (showing a stimulator device) and <FIG> (showing a cochlear implant). In an example, the sensory prosthesis <NUM> is a visual prosthesis, such as a retinal prosthesis.

In the illustrated example, the sensory prosthesis <NUM> includes a memory <NUM>, one or more processors <NUM>, and a stimulator <NUM>, among other components. In many examples, the sensory prosthesis <NUM> is a stimulator configured to cause the recipient to experience a sensory percept.

The memory <NUM> is one or more software- or hardware-based computer-readable storage media operable to store information accessible by the one or more processors <NUM>. Additional details regarding the memory <NUM> are described in relation to <FIG>. In the illustrated example, the memory <NUM> stores a log <NUM> and one or more maps <NUM>.

The log <NUM> is a set of one or more data structures that are records of data, activity, or events relevant to the sensory prosthesis <NUM>. In an example, the log <NUM> includes data regarding multiple fitting sessions. The one or more data structures of the log can be implemented in any of a variety of ways.

The maps <NUM> are one or more settings for the sensory prosthesis <NUM>. In an example, the one or more maps <NUM> describes an allocation of frequencies from a filter bank or other frequency analyzer to individual electrodes of the stimulator <NUM>. In an example, the one or more maps <NUM> describe electrical maps from sound levels in one or more or all of the frequency bands to electrical stimulation levels. The one or more maps <NUM> can be performed on a one-to-one basis, with each filter output is allocated to a single electrode. The one or more maps <NUM> can be created based on parameters, such as threshold levels (T levels) and maximum comfort levels (C levels) for one or more or all stimulation channels of the sensory prosthesis <NUM>. In an example, the one or more maps <NUM> are stored by programming the sensory prosthesis <NUM> or by any other process that sets the channels of the sensory prosthesis <NUM> to have the map <NUM>. Example maps and related techniques are described in <CIT> and <CIT>. Example maps are further described in the references incorporated below regarding fitting (see discussion of operation <NUM>, below).

The maps <NUM> can each be or include one or more parameters having values that affect how the sensory prosthesis <NUM> operates. For instance, the maps <NUM> can include a map <NUM> having minimum and maximum stimulation levels for frequency bands of stimulation channels. The map <NUM> is then used by the sensory prosthesis <NUM> to control an amount of stimulation to be provided. For instance, where the sensory prosthesis <NUM> is a cochlear implant, the map <NUM> affects which electrodes of the cochlear implant to stimulate and in what amount based on a received sound input. In some examples, the maps <NUM> include two or more predefined groupings of settings selectable by the recipient. One of the two or more predefined groupings of settings may be a default setting. In an example, the maps <NUM> can be ordered, such as based on relative loudness of the maps. For example, a first map <NUM> can have a lower loudness than an nth map <NUM>, where n is the highest numbered map <NUM>. In some examples, the differences between the maps <NUM> are simply intensity of stimulation. In other examples, there can be other differences between maps <NUM>. In some implementations, the maps <NUM> can have different shapes compared to one another. For instance, the maps can be based on principle component analysis.

The maps <NUM> can also include sound processing settings that modify sound input before it is converted into a stimulation signal. Such settings can include, for example, particular audio equalizer settings can boost or cut the intensity of sound at various frequencies. In examples, the maps <NUM> can include a minimum threshold for which received sound input causes stimulation, a maximum threshold for preventing stimulation above a level which would cause discomfort, gain parameters, loudness parameters, and compression parameters. The maps <NUM> can include settings that affect a dynamic range of stimulation produced by the sensory prosthesis <NUM>. As described above, many of the maps <NUM> affect the physical operation of the sensory prosthesis <NUM>, such as how the sensory prosthesis <NUM> provides stimulation to the recipient in response to sound input received from the environment <NUM>.

The one or more processors <NUM> include one or more hardware or software processors (e.g., microprocessors or central processing units). In many examples, the one or more processors <NUM> are configured to obtain and execute instructions from the memory <NUM>. Additional details regarding the one or more processors <NUM> are described in relation to <FIG>.

The stimulator <NUM> includes the stimulation generation and delivery components as well as additional support components of the sensory prosthesis <NUM>. Examples include an electronics module and stimulator assembly as described in more detail in <FIG>, the stimulator unit and elongate lead as described in more detail in <FIG>, and the sensor-stimulator of <FIG>. As a specific example, the stimulator <NUM> is or includes an auditory stimulator. The auditory stimulator can be a component configured to provide stimulation to a recipient's auditory system to cause a hearing percept to be experienced by the recipient. Examples of components usable for auditory stimulation include components for generating air-conducted vibrations, components for generating bone-conducted vibration, components for generating electrical stimulation, other components, or combinations thereof.

The recipient computing device <NUM> is a computing device associated with the recipient of the sensory prosthesis <NUM>. In many examples, the recipient computing device <NUM> is a cell phone, tablet, laptop, smart watch, or heart rate monitor, but can take other forms. As illustrated, the recipient computing device <NUM> includes memory <NUM> and one or more processors <NUM>.

As illustrated, the memory <NUM> includes fitting instructions <NUM>. The fitting instructions <NUM> can be instructions executable by the one or more processors <NUM> of the recipient computing device <NUM> to implement one or more methods or operations described herein. In some examples, the fitting instructions <NUM> are a part of instructions executable to provide a sensory prosthesis application <NUM>. In some examples, the memory <NUM> stores the log <NUM> and one or more maps <NUM>.

In examples, the recipient computing device <NUM> includes or implements the sensory prosthesis application <NUM> that operates on the recipient computing device <NUM> and cooperates with the sensory prosthesis <NUM>. For instance, the sensory prosthesis application <NUM> can control the sensory prosthesis <NUM> (e.g., based on input received from the recipient) and obtain data from the sensory prosthesis <NUM>. The recipient computing device <NUM> can connect to the sensory prosthesis <NUM> using, for example, a wireless radiofrequency communication protocol (e.g., BLUETOOTH). The sensory prosthesis application <NUM> transmits or receives data from the sensory prosthesis <NUM> over such a connection. The sensory prosthesis application <NUM> can also stream audio to the sensory prosthesis <NUM>, such as from a microphone of the recipient computing device <NUM> or an application running on the recipient computing device <NUM> (e.g., a video or audio application).

In some examples, the sensory prosthesis application <NUM> provides a fitting user interface <NUM>. The fitting user interface <NUM> is a user interface configured to obtain fitting information from the recipient. As illustrated, the fitting user interface <NUM> includes a query <NUM> to the user in the form of a text prompt and five user interface elements (e.g., buttons) selectable by the user and configured to obtain input from the recipient. As illustrated, the fitting user interface <NUM> includes a first user interface element <NUM> selectable to indicate that the stimulation is too loud, a second user interface element <NUM> selectable to indicate that the stimulation is a little loud, a third user interface element <NUM> selectable to indicate that the stimulation is just right, a third user interface element <NUM> selectable to indicate that the stimulation is a little soft, and a fifth user interface element <NUM> selectable to indicate that the stimulation is too soft. Other implementations of the user interface <NUM> are also usable. For example, slider user interface elements, drop down menus, and other systems can be used to receive input from the user.

The clinician computing device <NUM> is a computing device used by a clinician. A clinician is a medical professional, such as an audiologist. In an example, the clinician is a medical professional that provides care or supervision for the recipient. The clinician computing device <NUM> includes one or more software programs usable to monitor the sensory prosthesis <NUM>, such as fitting progress thereof. The clinician computing device <NUM> can include memory <NUM> and one or more processors <NUM>. In an example, the memory stores instructions that, when executed by the one or more processors <NUM> causes the one or more processors <NUM> to obtain data regarding fitting of the sensory prosthesis <NUM> (e.g., via the server <NUM> or by a direct connection between the sensory prosthesis <NUM> or the recipient computing device <NUM> and the clinician computing device <NUM>) and present such data to the clinician over a clinician user interface. In some examples, the data includes data stored in the log <NUM>.

The fitting server <NUM> is a server computing device remote from the sensory prosthesis <NUM>, recipient computing device <NUM>, and the clinician computing device <NUM>. The fitting server <NUM> is communicatively coupled to the recipient computing device <NUM> and the clinician computing device <NUM>. In many examples, the fitting server <NUM> is indirectly communicatively coupled to the sensory prosthesis <NUM> through the recipient computing device <NUM> (e.g., via the sensory prosthesis application <NUM>). In some examples, the fitting server <NUM> is directly communicatively coupled to the sensory prosthesis <NUM>. The fitting server <NUM> includes memory <NUM>, one or more processors <NUM>, and fitting software <NUM>. The fitting software <NUM> is software operable to perform one or more operations described herein, such as operations that fit the sensory prosthesis <NUM>. The fitting software <NUM> can customize the sensory prosthesis <NUM> based on feedback from the recipient or the clinician.

The components of the system <NUM> can cooperate to perform one or more methods that improves the performance of the sensory prosthesis <NUM>, such as by fitting the sensory prosthesis <NUM> and generating one or more clinician events. An example of such a method are described below in relation to <FIG>.

<FIG> illustrates a first non-claimed example method <NUM>. In an example, the method <NUM> is partially or wholly performed by the sensory prosthesis <NUM>. In an example, the method <NUM> is partially or wholly performed by the recipient computing device <NUM> communicatively coupled to the sensory prosthesis <NUM>.

Operation <NUM> includes performing an initial fitting. During the initial fitting, the sensory prosthesis <NUM> is tailored, customized, or otherwise adjusted for the specific needs, wants, or characteristics of the recipient of the sensory prosthesis <NUM>. For example, the initial fitting can be performed or led by a clinician at a clinic. In some examples, the initial fitting can be performed by a software system at a clinic. The initial fitting can produce one or more maps. Example fitting software includes CUSTOM SOUND PRO by COCHLEAR. Example techniques for fitting that can be used with techniques described herein are described at least at <CIT>, <CIT>, <CIT>, <CIT>, <CIT>, and <CIT>. In some examples, the initial fitting is the first time the sensory prosthesis <NUM> is fit to the recipient. In other examples, initial fitting can refer to a clinician-led fitting that occurs at a clinic. The initial fitting can be initial with respect to subsequent automated fitting and can act as a baseline fitting on which the subsequent fitting is based. Where the initial fitting is the first time the sensory prosthesis <NUM> is fit to the recipient, an initial map <NUM> may have relatively low intensity (e.g., to permit a recipient to become accustomed to artificial stimulation by the sensory prosthesis <NUM>).

Operation <NUM> includes performing automated fitting. For example, after the initial clinical fitting of the sensory prosthesis <NUM> to the recipient in operation <NUM>, the automated fitting of the sensory prosthesis <NUM> to the recipient can be performed. In an example, the automated fitting is performed by the sensory prosthesis <NUM>, the recipient computing device <NUM>, the clinician computing device <NUM> (e.g., remotely), the fitting server <NUM> (e.g., remotely, or combinations thereof (e.g., the sensory prosthesis <NUM> and the recipient computing device <NUM> cooperate to accomplish the automated fitting). The automated fitting can be performed, for example, outside of the clinic where the initial fitting took place. In an example, the automated fitting can be automated in the sense that the automated fitting is directed or led by an automated process (e.g., performed by fitting software) rather than directly led by a clinician. As described in more detail herein, the automated fitting can include manual input from the recipient (or a caregiver for the recipient). Where manual fitting input is received, the fitting of the sensory prosthesis <NUM> can be based on the manual fitting input. As described below, the automated fitting can include operations <NUM>, <NUM>, and <NUM>.

Operation <NUM> includes querying the recipient, such as regarding stimulation provided by the sensory prosthesis <NUM>. For example, the user interface <NUM> is provided by the recipient computing device <NUM> to provide a query <NUM>. In the illustrated example, the query <NUM> is regarding the quality of the stimulation. The query can be <NUM> rephrased in any of a variety of forms. Generally, the query <NUM> is configured to elicit a response from the recipient that is useful for fitting the sensory prosthesis <NUM>. The querying can further include providing one or more user interface elements selectable by the recipient to provide a response (see, e.g., user interface elements <NUM>, <NUM>, <NUM>, <NUM>, and <NUM>. Other input mechanisms can be presented or activated, such as a text box configured to receive text input from a user or by activating a microphone to receive voice input.

Operation <NUM> includes receiving a response to the querying. In an example, the response is received by detecting actuation of one or more of the user interface elements <NUM>, <NUM>, <NUM>, <NUM>, and <NUM>. In other examples, the response from the recipient can be received through another form, such as free text entry or via voice (e.g., which is then converted using a voice-to-text system into text) on which natural language processing is performed to understand the input.

Operation <NUM> includes modifying a map <NUM> of the sensory prosthesis <NUM> based on the received response. In an example, the operation can include changing one or more properties of the current map <NUM>. In another example, different map <NUM> of the maps <NUM> can be selected as the current map <NUM>. For instance, the modification can include changing the map <NUM> from a first map <NUM> stored on the sensory prosthesis <NUM> to a second map <NUM> stored on the sensory prosthesis.

Operation <NUM> includes logging the fitting. For example, the operation <NUM> can include logging the automated fitting in a log <NUM>. Logging can include storing data relevant to the fitting in the log <NUM>. The relevant data can include the identity of the current map <NUM>, the query <NUM> presented, the response to the query <NUM> that was received, the current date, the current time, the kind of environment <NUM> in which the sensory prosthesis <NUM> recently operated, other data, or combinations thereof. The logged data can further include data that can indicate a fitting progress. In some examples, the log <NUM> can be provided to different components of the system <NUM>, such as the recipient computing device <NUM> and the server <NUM>. In some examples, the recipient can view the log (or a visualization based on the log) using the sensory prosthesis application <NUM> (e.g., view the log locally or a remotely stored log).

Operation <NUM> includes analyzing the log <NUM> to determine fitting progress. For example, one or more statistical analyses can be performed in the data in the log <NUM>. In an example, operation <NUM> includes operation <NUM> and operation <NUM>.

Operation <NUM> includes determining fitting trajectory. The fitting trajectory can be one or more pieces of data or statistics that indicate how the automated fitting is progressing, has been progressing, or will progress. For example, the fitting trajectory can include data regarding changes to the mapping, such as a rate of change to the mapping (e.g., changes per week or per month). In a further example, the fitting trajectory can be a change in a dynamic range (e.g., the range between a threshold level and a comfort level) or rate of change in the dynamic range.

Operation <NUM> includes determining a change in level, such as a threshold level and a comfort level. In another example, the fitting trajectory can relate to change or rate of change in a particular characteristic of a map <NUM>, such as a comfort level and/or a threshold level.

Operation <NUM> includes determining whether fitting progress indicates a lack of progress. In an example, the operation <NUM> can include operations <NUM>, and <NUM>.

Operation <NUM> includes determining the fitting trajectory fails to meet a target trajectory. For example, the target trajectory can be a predetermined trajectory set by the fitting system or the clinician. In some examples, the target trajectory is determined based on automatically or manually analyzing clinical maps. Starting stimulation levels can be compared with final (e.g., goal) stimulation levels and determine an expected (e.g., median) increase over time from the starting (or current) stimulation level to reach the final stimulation level. In some examples, the target trajectory is determined based on one or more audiograms (e.g., the audibility of sounds in free field), which can be a way to determine the suitability of minimum stimulation levels. In some examples, the target trajectory is determined based on objective measures, such as electrophysiological responses of the auditory nerve or the brain.

Determining that the fitting trajectory fails to meet the target trajectory can include comparing the determined trajectory and the target trajectory. In some examples, the target is customized to the recipient. The target can be algorithmically generated or manually specified by a clinician. In some examples, the target is based on how other similar recipients progressed over a particular period of time. In some examples, one or more aspects of the target trajectory can be based on a time series of audiograms or other psychophysical assessments of the hearing ability of the user.

Operation <NUM> includes determining a change in level fails to meet a target level. For example, the target level can be a target comfort level, such as may be predetermined (e.g., set automatically or by the clinician). The determining can include comparing the current level with the target to see if the current level surpasses or otherwise satisfies the target level.

Operation <NUM> includes generating a clinician event. For example, the operation <NUM> can be performed responsive to determining that the fitting progress indicates a lack of progress. In an example, the clinician event can be reporting a fitting status of the sensory prosthesis <NUM> to the clinician. In some examples, the clinician event includes to cause the clinician computing device <NUM> to generate an alert. In an example, the operation <NUM> includes operation <NUM>. Operation <NUM> includes alerting the recipient to schedule an appointment, such as an appointment with a clinician. The appointment can be an appointment for a clinical fitting.

Operation <NUM> includes receiving manual fitting input. For example, the manual fitting input can be received outside of the automated fitting process (e.g., at a time when automated fitting is not occurring). The sensory prosthesis <NUM> can directly or indirectly (e.g., via the sensory prosthesis application <NUM>) receive the manual fitting input. For example the sensory prosthesis application <NUM> can receive input from the recipient that activates a user interface (e.g., which can include one or more features of the user interface <NUM>) over which the manual fitting input is received. The manual fitting input can include an input indicating that the stimulation provided by the sensory prosthesis <NUM> is undesirable to the recipient (e.g., by being too loud or too soft for a current or recent environment <NUM>).

Operation <NUM> includes fitting the sensory prosthesis <NUM> based on the manual fitting input. Where the manual fitting input indicates that the stimulation perceived by the recipient is too soft, the current map <NUM> of the sensory prosthesis <NUM> can be changed to a map <NUM> that provides more intense stimulation. Where the manual fitting input indicates that the stimulation perceived by the recipient is too intense, the current map <NUM> of the sensory prosthesis <NUM> can be changed to a map <NUM> that provides less intense stimulation. The current map <NUM> can be changed using one or more of the techniques described above in relation to the automated fitting in operation <NUM>.

Operation <NUM> includes detecting an out-of-bounds fitting. The out-of-bounds fitting can be a setting of a parameter or a mapping to a value that exceeds a maximum value or falls below a minimum value. For example, where the current map <NUM> is a loudest possible map <NUM> of the maps <NUM> (e.g., having the highest upper stimulation level), an attempt to increase the loudness of the current map <NUM> further can result in an out-of-bounds fitting. As another example, where the current map <NUM> is a softest possible map <NUM> of the maps <NUM> (e.g., having the lowest comfort level), an attempt to decrease the loudness of the current map <NUM> further can result in an out-of-bounds fitting. The out-of-bounds fitting can further be a fitting that violates one or more constraints, such as by attempting to set the comfort level lower than the threshold level. In an example, responsive to detecting the out-of-bounds fitting, the clinician event is generated. For instance, in response to detecting the out-of-bounds fitting, operation <NUM> is performed.

<FIG> illustrates one or more processors <NUM> configured to perform a second non-claimed example method <NUM>. For example, the one or more processors <NUM> can be communicatively coupled to memory storing instructions that, when executed by the one or more processors <NUM>, cause the one or more processors to perform the method <NUM>. The one or more processors <NUM> can be processors of one or more of: the sensory prosthesis <NUM>, the recipient computing device <NUM>, the clinician computing device <NUM>, or the fitting server <NUM>.

Operation <NUM> includes to receive an indication regarding quality of stimulation. Quality of stimulation can include, for example ,comfort, acceptance, loudness, speech intelligibility, visual intelligibility, other qualities, or combinations thereof. For example, operation <NUM> can include operation <NUM> and operation <NUM>. Operation <NUM> includes to query the recipient regarding stimulation. Where the sensory prosthesis <NUM> is an auditory prosthesis, the operation <NUM> can include querying the recipient regarding the stimulation provided by the auditory prosthesis. Where the sensory prosthesis <NUM> is a visual prosthesis, the operation <NUM> can include querying the recipient regarding the stimulation provided by the visual prosthesis. In an example, querying the recipient can include providing a user interface configured to receive input from the recipient. The user interface can be provided automatically or be manually accessed by the user (e.g., the recipient themselves or a caregiver of the recipient). For example, the operation <NUM> can include to provide a first user interface element <NUM> selectable to indicate that the stimulation is too loud, and provide a second user interface element <NUM> selectable to indicate that the stimulation is too soft. Additional example techniques that can be implemented are described above in operation <NUM>.

Operation <NUM> includes receiving the response to the querying. For example, the response can be received from a user over a user interface provided in operation <NUM>. Additional example techniques that can be implemented are described above in operation <NUM>.

Operation <NUM> includes to modify a current map, such as based on the quality of stimulation. Example techniques that can be used to implement operation <NUM> are described above in operation <NUM>. In an example, operation <NUM> includes operations <NUM>, <NUM>, <NUM>, <NUM>, <NUM>, and <NUM>.

Operation <NUM> includes to determine that stimulation is too loud (e.g., the intensity of stimulation is too high). For example, determining that the stimulation is too loud can be responsive to receiving input from a user (e.g., the recipient or a caretaker thereof) indicating that the stimulation is too loud. In addition or instead, determining that the stimulation is too loud can be determined based on activity of the recipient, such as the recipient operating the sensory prosthesis <NUM> with a low volume setting or attempting to lower the volume of the sensory prosthesis <NUM> (e.g., below a minimum volume).

Operation <NUM> includes to decrement a current map. For example, the operation <NUM> can be performed responsive to determining that the stimulation is too loud. Decrementing the current map <NUM> can include changing the current map <NUM> to a different map <NUM> that has an identifier that is one (or a different value) less than the identifier of the current map <NUM> (e.g., in pseudocode, current_map_id = current_map_id - <NUM>).

Operation <NUM> includes to determine that the stimulation is too soft (e.g., the intensity of stimulation is too low). For example, determining that the stimulation is too soft can be responsive to receiving input from a user (e.g., the recipient or a caretaker thereof) indicating that the stimulation is too soft. In addition or instead, determining that the stimulation is too soft can be determined based on activity of the recipient, such as the recipient operating the sensory prosthesis <NUM> with a high volume setting or attempting to increase the volume of the sensory prosthesis <NUM> (e.g., beyond a maximum volume).

Operation <NUM> includes to increment the current map. For example, the operation <NUM> can be performed responsive to determining that the stimulation is too soft. Incrementing the current map <NUM> can include changing the current map <NUM> to a different map <NUM> that has an identifier that is one greater than the identifier of the current map <NUM> (e.g., in pseudocode, current_map_id = current_map_id + <NUM>). The maps <NUM> can be associated with any of a variety of different identifiers. In some examples, incrementing (or decrementing) a map <NUM> can correspond to changing a program number. In other examples, the incrementing or decrementing of a map <NUM> does not correspond to changing a program number. In some examples, the maps <NUM> can be created using a technique (e.g., one or more data analysis techniques) and then the maps <NUM> are ranked. For example, the maps <NUM> can be ranked based on relative loudness, such that relatively higher ranked maps are relatively louder.

Operation <NUM> includes to detect an out-of-bounds fitting. For example, the operation <NUM> can include detecting an attempt to decrement the current map <NUM> beneath a map floor or attempting to increment the current map <NUM> above a map ceiling. For example, a sensory prosthesis <NUM> can include n maps <NUM> numbered from zero through n (inclusive). Detecting the out-of-bounds fitting can include attempting to change the current map <NUM> to a value less than zero or greater than n. Additional example techniques that can be implemented are described above in operation <NUM>.

Operation <NUM> includes to modify the current map <NUM> based on a received response. Example techniques that can be implemented are described above in operation <NUM>.

Operation <NUM> includes to determine a difference between a current map <NUM> and target map. For example, to determine the difference can include to determine a difference between an identifier of the current map <NUM> and an identifier of a target map. For instance, the target map <NUM> may be map <NUM> number seven and the current map <NUM> is map <NUM> number eight. Thus, the current map <NUM> is one greater than the target map. In another example, determining the difference between the current map <NUM> and the target map <NUM> can include comparing differences in parameters or other characteristics of the maps. For instance, a threshold or comfort level of the two maps is compared.

Operation <NUM> includes to determine whether the difference satisfies the threshold. For instance, the threshold can be the current map <NUM> being greater than or less than a predetermined threshold. In another example, the threshold can be the current map <NUM> having a particular characteristic that is greater than or less than a predetermined threshold.

Operation <NUM> includes to generate a clinician event. For example, the clinician event can be generated responsive to the difference failing to satisfy the threshold.

Operation <NUM> includes to detect actuation of a first user interface element. For example, a first user interface element <NUM> can be provided that is selectable to indicate that the stimulation is too loud.

Operation <NUM> includes to determine whether a loud environment was detected proximate the recipient. For example, it can be determined based on whether the loud environment was detected within a threshold amount of time. For instance, data regarding the environment <NUM> can be stored in the log <NUM> and the determining can be performed by analyzing the log <NUM>.

Operation <NUM> includes to decrement the current map <NUM>. For example, the current map <NUM> can be decremented responsive to the determining that the loud environment was detected proximate the recipient within the threshold amount of time. Decrementing the current map <NUM> can include changing the current map <NUM> to a different map <NUM> that has an identifier that is one (or a different value) less than the identifier of the current map <NUM>.

Operation <NUM> includes to detect actuation of a second user interface element <NUM>. For example, a second user interface element <NUM> can be provided that is selectable to indicate that the stimulation is too soft.

Operation <NUM> includes to determine whether the loud environment was detected proximate the recipient, such as is described in relation to operation <NUM>.

Operation <NUM> includes to inform the recipient of no change. For example, responsive to the loud environment being detected proximate to the recipient within a threshold amount of time, the operation <NUM> can be performed.

<FIG> illustrates instructions <NUM> that, when executed by one or more processors <NUM> cause the one or more processors <NUM> to perform a third non-claimed method <NUM> that includes one or more operations. The instructions <NUM> can be stored on a computer-readable medium that is a component of the sensory prosthesis <NUM>, recipient computing device <NUM>, clinician computing device <NUM>, and the fitting server <NUM>. In an example, the recipient computing device <NUM> is communicatively coupled to the sensory prosthesis <NUM>.

Operation <NUM> includes to perform automated fitting. In an example, the operation <NUM> includes to perform after an initial clinical fitting of a sensory prosthesis <NUM> to a recipient, perform automated fitting of the sensory prosthesis <NUM> to the recipient. The operation <NUM> can include one or more aspects of operation <NUM>, which describes performing automated fitting.

Operation <NUM> includes to query the recipient regarding stimulation provided by the sensory prosthesis <NUM>. The operation <NUM> can include one or more aspects of operation <NUM>, which describes querying the recipient.

Operation <NUM> includes to receive the response to the query from the recipient. The operation <NUM> can include one or more aspects of operation <NUM>, which describes receiving a response to a query.

Operation <NUM> includes to modify the map <NUM> based on the received response. The operation <NUM> can include one or more aspects of operation <NUM>, which describes modifying a map. In some examples, operation <NUM> includes operation <NUM>. Operation <NUM> includes to change from a first map <NUM> to a second map <NUM>. For example, the operation <NUM> can include changing the map <NUM> from a first map <NUM> stored on the sensory prosthesis <NUM> to a second map <NUM> stored on the sensory prosthesis. In other examples, the maps <NUM> can be stored elsewhere.

Operation <NUM> includes to determine fitting progress of the automated fitting. The operation <NUM> can include one or more aspects of operation <NUM>, which describes determining fitting progress.

Operation <NUM> includes to determine a fitting trajectory. The operation <NUM> can include one or more aspects of operation <NUM>, which describes determining a fitting trajectory.

Operation <NUM> includes to determine that the fitting trajectory fails to meet a target trajectory. The operation <NUM> can include one or more aspects of operation <NUM>, which describes determining that the fitting trajectory fails to meet the target trajectory.

Operation <NUM> includes to determine a change in level. The operation <NUM> can include one or more aspects of operation <NUM>, which describes determining a change in level.

Operation <NUM> includes to determine the change in level fails to meet a target level. The operation <NUM> can include one or more aspects of operation <NUM>, which describes determining that the change in level fails to meet a target level.

Operation <NUM> includes to generate a clinician event. For example, the operation <NUM> can be performed responsive determining that the fitting progress indicates a lack of progress. The operation <NUM> can include one or more aspects of operation <NUM>, which describes generating a clinician event. Operation <NUM> includes to alert a recipient to schedule an appointment. The operation <NUM> can include one or more aspects of operation <NUM>, which describes alerting a recipient to schedule an appointment.

<FIG>, which is made up of <FIG>, <FIG>, and <FIG>, illustrates a non-claimed method <NUM>. As shown in the figures, certain operations can be performed at a clinic and others can be performed out of the clinic (e.g., at home).

Operation <NUM> includes performing automated sensory prosthesis diagnostics. In an example, the automated sensory prosthesis diagnostics includes automated impedance check and electrode. The operation <NUM> can produce a log or report describing the status of various components of the sensory prosthesis <NUM>. The log or report can facilitate diagnosing actual or potential faults with the device. Example automated diagnostics processes are described, for example, at <CIT> (describing detecting neotissue formation proximate a sensory prosthesis), <CIT> (describing detecting a physical state of a stimulating assembly), <CIT> (describing performing diagnostic testing on implanted devices), and <CIT> (describing determining impedance-related phenomena in a vibrating actuator).

Operation <NUM> includes enabling automated fitting. In an example, the operation <NUM> includes the recipient, caregiver, or clinician choosing an automated option for fitting. The automated fitting can be a setting that is enabled on the sensory prosthesis <NUM>. For instance, a flag can be set that enables automated fitting.

Operation <NUM> includes fitting software creating a map <NUM>. The creating of a map <NUM> can be, for example, the creation of an initial map <NUM> for the recipient as part of an initial fitting. In another example, the fitting can be part of a routine fitting process (e.g., a fitting process that typically occurs at checkups of the recipient by the clinician).

Operation <NUM> includes the clinician going live on the map <NUM>. This operation can include activating the map <NUM> such that the sensory prosthesis <NUM> operates with the map <NUM> being the current map <NUM>. In some examples, the map <NUM> is first transferred to the sensory prosthesis <NUM> (see, e.g., operation <NUM>).

Operation <NUM> includes onboarding the recipient. For example, the onboarding can include providing the sensory prosthesis application <NUM> to the recipient or the recipient computing device <NUM>. The onboarding can include downloading the sensory prosthesis application <NUM> from an application distribution platform (e.g., the APPLE APP STORE or GOOGLE PLAY) to the recipient computing device. The operation <NUM> can further include installing and configuring the sensory prosthesis application <NUM>.

Operation <NUM> includes providing the map <NUM> to the sensory prosthesis <NUM>. For example, the fitting software transmits the map <NUM> to sensory prosthesis <NUM>.

Operation <NUM> includes the application setting the map <NUM> as the current map <NUM>. For example, the map <NUM> can be set as map <NUM> one, such that an indicator of the identifier of the current map <NUM> (N) is set to one.

Operation <NUM> includes training the recipient on use of the application. For example, the recipient can be provided with education materials or instruction from the clinician.

Turning to <FIG>, Operation <NUM> includes a trigger occurring. For example, the trigger can be a trigger that causes the performance of automated fitting. Example triggers include a time-based triggers (e.g., the trigger activates once daily, weekly, or monthly or at other intervals), action-based triggers (e.g., responsive to detecting the occurrence of an action, such as the changing of volume or other settings more than a threshold amount of times), or manual triggers (e.g., the clinician or recipient expressly causing the trigger to activate). In an example, the trigger is based on the recipient computing device <NUM> (e.g., the determination of whether the trigger activates is performed on the recipient computing device <NUM>). In other examples, the trigger is located at another component of the system <NUM> or at multiple different locations. Responsive to the trigger occurring, the flow of the method <NUM> can move to operation <NUM>.

Operation <NUM> includes querying the recipient whether the recipient received uncomfortable stimulation. For example, the user interface <NUM> is provided by the recipient computing device <NUM> to provide a query <NUM> that asks whether the recipient received uncomfortable stimulation. The querying can further include providing one or more user interface elements selectable by the recipient to provide a response. Other input mechanisms can be presented or activated, such as a text box configured to receive text input from a user or by activating a microphone to receive voice input. The operation <NUM> can further include receiving an answer to the query from the recipient.

Responsive to the response indicating that the recipient received uncomfortable stimulation, the flow of the method <NUM> can move to operation <NUM>. Responsive to a response indicating that the recipient did not receive uncomfortable stimulation, the flow of the method <NUM> can move to operation <NUM>.

Operation <NUM> includes querying the recipient whether the recipient received sounds that were too loud. For example, the user interface <NUM> is provided by the recipient computing device <NUM> to provide a query <NUM> that asks whether the recipient received sounds that were too loud (e.g., the stimulation was too loud because the stimulation was too intense). The querying can further include providing one or more user interface elements selectable by the recipient to provide a response. Other input mechanisms can be presented or activated, such as a text box configured to receive text input from a user or by activating a microphone to receive voice input. The operation <NUM> can further include receiving an answer to the query from the recipient.

Responsive to the response indicating that the recipient received uncomfortable stimulation, the flow of the method <NUM> can move to operation <NUM>. Responsive to a response indicating that the recipient did not receive uncomfortable stimulation, it is determined whether the current map <NUM> is the lowest-loudness map <NUM> available (e.g., readily available to switch to by the sensory prosthesis <NUM>, such as by being stored on the sensory prosthesis <NUM> or the recipient computing device <NUM>). For example, the determining can include determining whether the current map <NUM> is the zero-th map <NUM> (where maps are indexed from zero and the zero-th map <NUM> is the softest map). Responsive to the current map <NUM> being the lowest-loudness map <NUM> available, the flow of the method moves to operation <NUM>. Responsive to the current loudness map <NUM> not being the lowest-loudness map <NUM> available, the flow of the method <NUM> moves to operation <NUM>.

Operation <NUM> includes generating a clinician event. For example, the generating of the clinician event can include one or more aspects of operation <NUM>. In some examples, this operation <NUM> is arrived at because the recipient indicated that the recipient received uncomfortable stimulation that was not too loud. Such a combination of responses may indicate that the recipient is perceiving unintended stimulation (e.g., non-auditory stimulation, where the sensory prosthesis <NUM> is an auditory prosthesis).

Operation <NUM> includes querying the recipient regarding softness and loudness. For example, the operation <NUM> can include providing a query <NUM> to the user in the form of a user interface <NUM> that includes a text prompt and user interface elements (e.g., buttons) selectable to obtain input from the recipient. For example, the user interface <NUM> can be as shown in <FIG>. The user interface <NUM> can include a first user interface element <NUM> selectable to indicate that the stimulation is too loud, a second user interface element <NUM> selectable to indicate that the stimulation is a little loud, a third user interface element <NUM> selectable to indicate that the stimulation is just right, a third user interface element <NUM> selectable to indicate that the stimulation is a little soft, and a fifth user interface element <NUM> selectable to indicate that the stimulation is too soft. Other implementations of the user interface <NUM> are also usable. The operation <NUM> can further include receiving a response from the recipient, such as based on the actuation of one or more of the user interface elements <NUM>, <NUM>, <NUM>, <NUM>, and <NUM>.

Responsive to the response to the query indicating that stimulation is too soft, the flow of the method <NUM> can move to operation <NUM>. Responsive to the response to the query indicating that stimulation is moderate (e.g., just right or comfortable), the flow of the method <NUM> can move to a next determination. The next determination can be whether the next loudest map <NUM> compared to the current map <NUM> (e.g., the map <NUM> having an identifier being one greater than the identifier of the current map, where higher identifier numbers are associated with higher loudness) has been tried more than a threshold amount (e.g., more than two times). If so, the flow of the method can move to operation <NUM>. If not, the flow of the method <NUM>.

Operation <NUM> includes to increment a current map. For example, incrementing the current map <NUM> can include selecting a next-loudest map <NUM> as the current map <NUM>. For example, to increment the current map <NUM> can include to change the current map <NUM> from the nth map <NUM> to the (n + <NUM>)th map. The operation <NUM> can further include incrementing a portion of the log <NUM> that tracks how many times the (unincremented) map <NUM> has been tried.

Operation <NUM> includes to determine that the map <NUM> is stable. For example, the operation can be reached after determining that the recipient has tried the next loudest map <NUM> more than a threshold number of times and the recipient indicates that the current stimulation has medium intensity. The operation <NUM> can include ending a first map phase. For example, the trigger of operation <NUM> can be disabled until a next map phase begins.

Operation <NUM> includes to generate a clinician event. For example, the initial map <NUM> set in the clinic may have been set incorrectly (e.g., too loud). In an example, the operation <NUM> includes one or more aspects as described in operation <NUM>.

Operation <NUM> includes to decrement a current map. For example, decrementing the current map <NUM> can include selecting a next-softest map <NUM> as the current map. For example, to decrement the current map <NUM> can include to change the current map <NUM> from the nth map to the (n - <NUM>)th map. The operation <NUM> can further include incrementing a portion of the log <NUM> that tracks how many times a log has been tried.

Turning to <FIG>, operation <NUM> includes to wait for to receive a user input. For example, operation <NUM> can represent a thread, process, or interrupt that, upon detecting a user input, proceeds with the other operations described in <FIG>. In an example, the operation <NUM> can be non-blocking and the waiting for user input can occur while one or more other operations or processes are being performed. In an example, the operation <NUM> can be performed while a particular user interface is being presented, such as user interface <NUM>.

Responsive to receiving an input indicating that the current stimulation is too soft, the flow of the method can move to operation <NUM>. Responsive to receiving an input indicating that the current stimulation is too loud, the flow of the method can move to operation <NUM>.

Operation <NUM> includes to check the log. For example, the log <NUM> can be checked or analyzed to determine whether the recipient was proximate a loud environment for longer than a threshold amount of time. The operation can include searching or querying the log <NUM> for entries containing information relating to environments <NUM> in which the sensory prosthesis <NUM> was operating. For example, the log <NUM> can include indications of loudness of signals detected by a microphone or other sensor of the sensory prosthesis <NUM>. Following operation <NUM>, the flow of the method <NUM> can move to operation <NUM>.

Operation <NUM> includes to determine whether the recipient was proximate a loud environment for a period of time. For example, the analysis performed in operation <NUM> can be used to determine whether the recipient was in an environment louder than a threshold for longer than a threshold amount of time.

Operation <NUM> includes to increment the current map. For example, incrementing the current map <NUM> can include changing the current map <NUM> to a different map <NUM> that has an identifier that is one greater than the identifier of the current map <NUM> (e.g., in pseudocode, current_map_id = current_map_id + <NUM>).

Operation <NUM> includes to reset the log <NUM>. In some examples, resetting the log <NUM> can include deleting one or more entries of the log <NUM>. In some examples, resetting the log <NUM> can include marking one or more entries of the log <NUM> as already having been considered or used (e.g., such that the already considered entries are not used for determining whether the user had been in a loud environment as in operation <NUM>). Following operation <NUM>, the flow of the method <NUM> can move to operation <NUM>.

Operation <NUM> includes to inform the user of no change. For example, the operation <NUM> can be performed responsive to the recipient indicating that the sound is too soft but that the user has not been in a loud environment. For example, the user may think that the sound was too soft but in fact the environment was relatively soft. As such, it may be advantageous to avoid making a change to the current map. The user can be informed that no change was made because the recipient was not in a loud environment.

Operation <NUM> includes to decrement the current map. Decrementing the current map <NUM> can include changing the current map <NUM> to a different map <NUM> that has an identifier that is one (or a different value) less than the identifier of the current map <NUM>. Following operation <NUM>, the flow of the method <NUM> can move to operation <NUM>.

As previously described, the technology disclosed herein can be applied in any of a variety of circumstances and with a variety of different devices. For example, the sensory prosthesis <NUM> can take the form of a variety of different consumer devices or medical devices. Example consumer devices include headphones, earbuds, personal sound amplification products, wireless earbuds, or other consumer devices. Example medical devices include auditory prostheses and visual prostheses. Example auditory prostheses include one or more prostheses selected from the group consisting of: a cochlear implant, an electroacoustic device, a percutaneous bone conduction device, a passive transcutaneous bone conduction device, an active transcutaneous bone conduction device, a middle ear device, a totally-implantable auditory device, a mostly-implantable auditory device, an auditory brainstem implant device, a hearing aid, and a tooth-anchored hearing device. Example visual prostheses include bionic eyes.

Specific example devices that can benefit from technology disclosed herein are described in more detail in <FIG>, below. For example, the techniques described herein can be used to select broadcasts for medical devices, such as an implantable stimulation system as described in <FIG>, a cochlear implant as described in <FIG>, or a retinal prosthesis as described in <FIG>.

<FIG> is a functional block diagram of an implantable stimulator system <NUM> that can benefit from the technologies described herein. In an example, the sensory prosthesis <NUM> corresponds to the implantable stimulator system <NUM>. The implantable stimulator system <NUM> includes a wearable device <NUM> acting as an external processor device and an implantable device <NUM> acting as an implanted stimulator device. In examples, the implantable device <NUM> is an implantable stimulator device configured to be implanted beneath a recipient's tissue (e.g., skin). In examples, the implantable device <NUM> includes a biocompatible implantable housing <NUM>. Here, the wearable device <NUM> is configured to transcutaneously couple with the implantable device <NUM> via a wireless connection to provide additional functionality to the implantable device <NUM>.

In the illustrated example, the wearable device <NUM> includes one or more sensors <NUM>, a memory <NUM>, processor <NUM>, a transceiver <NUM>, and a power source <NUM>. The one or more sensors <NUM> can be units configured to produce data based on sensed activities. In an example where the stimulation system <NUM> is an auditory prosthesis system, the one or more sensors <NUM> include sound input sensors, such as a microphone. Where the stimulation system <NUM> is a visual prosthesis system, the one or more sensors <NUM> can include one or more cameras or other visual sensors. The processor <NUM> can be a component (e.g., a central processing unit) configured to control stimulation provided by the implantable device <NUM>. The stimulation can be controlled based on data from the sensor <NUM>, a stimulation schedule, or other data. Where the stimulation system <NUM> is an auditory prosthesis, the processor <NUM> can be configured to convert sound signals received from the sensor(s) <NUM> (e.g., acting as a sound input unit) into signals <NUM>. The transceiver <NUM> is configured to send the signals <NUM> in the form of power signals, data signals, combinations thereof (e.g., by interleaving the signals), or other signals. The transceiver <NUM> can also be configured to receive power or data. Stimulation signals can be generated by the processor <NUM> and transmitted, using the transceiver <NUM>, to the implantable device <NUM> for use in providing stimulation.

In the illustrated example, the implantable device <NUM> includes a transceiver <NUM>, a power source <NUM>, a coil <NUM>, and a stimulator <NUM> that includes an electronics module <NUM> and a stimulator assembly <NUM>. The implantable device <NUM> further includes a hermetically sealed, biocompatible housing enclosing one or more of the components.

The electronics module <NUM> can include one or more other components to provide sensory prosthesis functionality. In many examples, the electronics module <NUM> includes one or more components for receiving a signal (e.g., from one or more of the sensors <NUM>) and converting the signal into the stimulation signal <NUM>. The electronics module <NUM> can further be or include a stimulator unit. The electronics module <NUM> can generate or control delivery of the stimulation signals <NUM> to the stimulator assembly <NUM>. In examples, the electronics module <NUM> includes one or more processors (e.g., central processing units or microcontrollers) coupled to memory components (e.g., flash memory) storing instructions that when executed cause performance of an operation. In examples, the electronics module <NUM> generates and monitors parameters associated with generating and delivering the stimulus (e.g., output voltage, output current, or line impedance). In examples, the electronics module <NUM> generates a telemetry signal (e.g., a data signal) that includes telemetry data. The electronics module <NUM> can send the telemetry signal to the wearable device <NUM> or store the telemetry signal in memory for later use or retrieval.

The stimulator assembly <NUM> can be a component configured to provide stimulation to target tissue. In the illustrated example, the stimulator assembly <NUM> is an electrode assembly that includes an array of electrode contacts disposed on a lead. The lead can be disposed proximate tissue to be stimulated. Where the system <NUM> is a cochlear implant system, the stimulator assembly <NUM> is insertable into the recipient's cochlea. The stimulator assembly <NUM> can be configured to deliver stimulation signals <NUM> (e.g., electrical stimulation signals) generated by the electronics module <NUM> to the cochlea to cause the recipient to experience a hearing percept. In other examples, the stimulator assembly <NUM> is a vibratory actuator disposed inside or outside of a housing of the implantable device <NUM> and configured to generate vibrations. The vibratory actuator receives the stimulation signals <NUM> and, based thereon, generates a mechanical output force in the form of vibrations. The actuator can deliver the vibrations to the skull of the recipient in a manner that produces motion or vibration of the recipient's skull, thereby causing a hearing percept by activating the hair cells in the recipient's cochlea via cochlea fluid motion.

The transceivers <NUM> can be components configured to transcutaneously receive and/or transmit a signal <NUM> (e.g., a power signal and/or a data signal). The transceiver <NUM> can be a collection of one or more components that form part of a transcutaneous energy or data transfer system to transfer the signal <NUM> between the wearable device <NUM> and the implantable device <NUM>. Various types of signal transfer, such as electromagnetic, capacitive, and inductive transfer, can be used to usably receive or transmit the signal <NUM>. The transceiver <NUM> can include or be electrically connected to the coil <NUM>.

The coils <NUM> can be components configured to receive or transmit a signal <NUM>, typically via an inductive arrangement formed by multiple turns of wire. In examples, in addition to or instead of a coil, other arrangements are used, such as an antenna or capacitive plates. The magnets can be used to align respective coils <NUM> of the wearable device <NUM> and the implantable device <NUM>. For example, the coil <NUM> of the implantable device <NUM> is disposed in relation to (e.g., in a coaxial relationship) with an implantable magnet set to facilitate orienting the coil <NUM> in relation to the coil <NUM> of the wearable device <NUM> via the force of a magnetic connection. The coil <NUM> of the wearable device <NUM> can be disposed in relation to (e.g., in a coaxial relationship) with a magnet set.

The power source <NUM> can be one or more components configured to provide operational power to other components. The power source <NUM> can be or include one or more rechargeable batteries. Power for the batteries can be received from a source and stored in the battery. The power can then be distributed to the other components of the implantable device <NUM> as needed for operation.

<FIG> illustrates an example cochlear implant system <NUM> that can benefit from use of the technologies disclosed herein. For example, the cochlear implant system <NUM> can be used to implement the sensory prosthesis <NUM>. The cochlear implant system <NUM> includes an implantable component <NUM> typically having an internal receiver/transceiver unit <NUM>, a stimulator unit <NUM>, and an elongate lead <NUM>. The internal receiver/transceiver unit <NUM> permits the cochlear implant system <NUM> to receive signals from and/or transmit signals to an external device <NUM>. The external device <NUM> can be a button sound processor worn on the head that includes a receiver/transceiver coil <NUM> and sound processing components. Alternatively, the external device <NUM> can be just a transmitter/transceiver coil in communication with a behind-the-ear device that includes the sound processing components and microphone.

The implantable component <NUM> includes an internal coil <NUM>, and preferably, an implanted magnet fixed relative to the internal coil <NUM>. The magnet can be embedded in a pliable silicone or other biocompatible encapsulant, along with the internal coil <NUM>. Signals sent generally correspond to external sound <NUM>. The internal receiver/transceiver unit <NUM> and the stimulator unit <NUM> are hermetically sealed within a biocompatible housing, sometimes collectively referred to as a stimulator/receiver unit. Included magnets can facilitate the operational alignment of an external coil <NUM> and the internal coil <NUM> (e.g., via a magnetic connection), enabling the internal coil <NUM> to receive power and stimulation data from the external coil <NUM>. The external coil <NUM> is contained within an external portion. The elongate lead <NUM> has a proximal end connected to the stimulator unit <NUM>, and a distal end <NUM> implanted in a cochlea <NUM> of the recipient. The elongate lead <NUM> extends from stimulator unit <NUM> to the cochlea <NUM> through a mastoid bone <NUM> of the recipient. The elongate lead <NUM> is used to provide electrical stimulation to the cochlea <NUM> based on the stimulation data. The stimulation data can be created based on the external sound <NUM> using the sound processing components and based on sensory prosthesis settings.

In certain examples, the external coil <NUM> transmits electrical signals (e.g., power and stimulation data) to the internal coil <NUM> via a radio frequency (RF) link. The internal coil <NUM> is typically a wire antenna coil having multiple turns of electrically insulated single-strand or multi-strand platinum or gold wire. The electrical insulation of the internal coil <NUM> can be provided by a flexible silicone molding. Various types of energy transfer, such as infrared (IR), electromagnetic, capacitive and inductive transfer, can be used to transfer the power and/or data from external device to cochlear implant. While the above description has described internal and external coils being formed from insulated wire, in many cases, the internal and/or external coils can be implemented via electrically conductive traces.

<FIG> illustrates a retinal prosthesis system <NUM> that comprises an external device <NUM>, a retinal prosthesis <NUM> and a mobile computing device <NUM>. The retinal prosthesis system <NUM> can correspond to the sensory prosthesis <NUM>. The retinal prosthesis <NUM> comprises a processing module <NUM> and a retinal prosthesis sensor-stimulator <NUM> is positioned proximate the retina <NUM> of a recipient. The external device <NUM> and the processing module <NUM> can both include transmission coils <NUM> aligned via respective magnet sets. Signals <NUM> can be transmitted using the coils <NUM>.

In an example, sensory inputs (e.g., photons entering the eye) are absorbed by a microelectronic array of the sensor-stimulator <NUM> that is hybridized to a glass piece <NUM> including, for example, an embedded array of microwires. The glass can have a curved surface that conforms to the inner radius of the retina. The sensor-stimulator <NUM> can include a microelectronic imaging device that can be made of thin silicon containing integrated circuitry that convert the incident photons to an electronic charge.

The processing module <NUM> includes an image processor <NUM> that is in signal communication with the sensor-stimulator <NUM> via, for example, a lead <NUM> which extends through surgical incision <NUM> formed in the eye wall. In other examples, processing module <NUM> is in wireless communication with the sensor-stimulator <NUM>. The image processor <NUM> processes the input into the sensor-stimulator <NUM>, and provides control signals back to the sensor-stimulator <NUM> so the device can provide an output to the optic nerve. That said, in an alternate example, the processing is executed by a component proximate to, or integrated with, the sensor-stimulator <NUM>. The electric charge resulting from the conversion of the incident photons is converted to a proportional amount of electronic current which is input to a nearby retinal cell layer. The cells fire and a signal is sent to the optic nerve, thus inducing a sight perception.

The processing module <NUM> can be implanted in the recipient and function by communicating with the external device <NUM>, such as a behind-the-ear unit, a pair of eyeglasses, etc. The external device <NUM> can include an external light / image capture device (e.g., located in / on a behind-the-ear device or a pair of glasses, etc.), while, as noted above, in some examples, the sensor-stimulator <NUM> captures light / images, which sensor-stimulator is implanted in the recipient.

Similar to the above examples, the retinal prosthesis system <NUM> may be used in spatial regions that have at least one controllable network connected device associated therewith (e.g., located therein). As such, the processing module <NUM> includes a performance monitoring engine <NUM> that is configured to obtain data relating to a "sensory outcome" or "sensory performance" of the recipient of the retinal prosthesis <NUM> in the spatial region. As used herein, a "sensory outcome" or "sensory performance" of the recipient of a sensory prosthesis, such as retinal prosthesis <NUM>, is an estimate or measure of how effectively stimulation signals delivered to the recipient represent sensor input captured from the ambient environment.

Data representing the performance of the retinal prosthesis <NUM> in the spatial region is provided to the mobile computing device <NUM> and analyzed by a network connected device assessment engine <NUM> in view of the operational capabilities of the at least one controllable network connected device associated with the spatial region. For example, the network connected device assessment engine <NUM> may determine one or more effects of the controllable network connected device on the sensory outcome of the recipient within the spatial region. The network connected device assessment engine <NUM> is configured to determine one or more operational changes to the at least one controllable network connected device that are estimated to improve the sensory outcome of the recipient within the spatial region and, accordingly, initiate the one or more operational changes to the at least one controllable network connected device.

<FIG> illustrates an example of a suitable computing system <NUM> with which one or more of the disclosed examples can be implemented. Computing systems, environments, or configurations that suitable for use with examples described herein include, but are not limited to, personal computers, server computers, hand-held devices, laptop devices, multiprocessor systems, microprocessor-based systems, programmable consumer electronics (e.g., smart phones), network PCs, minicomputers, mainframe computers, tablets, distributed computing environments that include any of the above systems or devices, and the like. The computing system <NUM> can be a single virtual or physical device operating in a networked environment over communication links to one or more remote devices. In examples, the sensory prosthesis <NUM>, the recipient computing device <NUM>, the clinician computing device <NUM>, and the fitting server <NUM> can include one or more components or variations of components of the computing system <NUM>.

In its most basic configuration, computing system <NUM> includes memory <NUM> and one or more processors <NUM>. In the illustrated example, the system <NUM> further includes a network adapter <NUM>, one or more input devices <NUM>, and one or more output devices <NUM>. The system <NUM> can include other components, such as a system bus, component interfaces, a graphics system, a power source (e.g., a battery), among other components.

The memory <NUM> is one or more software- or hardware-based computer-readable storage media operable to store information accessible by the one or more processors <NUM>. The memory <NUM> can store, among other things, instructions executable by the one or more processors <NUM> to implement applications or cause performance of operations described herein, as well as other data. The memory <NUM> can be volatile memory (e.g., RAM), non-volatile memory (e.g., ROM), or combinations thereof. The memory <NUM> can include transitory memory or non-transitory memory. The memory <NUM> can also include one or more removable or non-removable storage devices. In examples, the memory <NUM> can include RAM, ROM, EEPROM (Electronically-Erasable Programmable Read-Only Memory), flash memory, optical disc storage, magnetic storage, solid state storage, or any other memory media usable to store information for later access. In examples, the memory <NUM> encompasses a modulated data signal (e.g., a signal that has one or more of its characteristics set or changed in such a manner as to encode information in the signal), such as a carrier wave or other transport mechanism and includes any information delivery media. By way of example, and not limitation, the memory <NUM> can include wired media such as a wired network or direct-wired connection, and wireless media such as acoustic, RF, infrared and other wireless media or combinations thereof.

The one or more processors <NUM> include one or more hardware or software processors. example processors include microprocessors and central processing units. In many examples, the one or more processors <NUM> are configured to obtain and execute instructions, such as instructions stored in the memory <NUM>. The one or more processors <NUM> can communicate with and control the performance of other components of the computing system <NUM>.

The network adapter <NUM> is a component of the computing system <NUM> that provides network access. The network adapter <NUM> can provide wired or wireless network access and can support one or more of a variety of communication technologies and protocols, such as ETHERNET, cellular, BLUETOOTH, near-field communication, and RF (Radiofrequency), among others. The network adapter <NUM> can include one or more antennas and associated components configured for wireless communication according to one or more wireless communication technologies and protocols.

The one or more input devices <NUM> are devices over which the computing system <NUM> receives input from a user. The one or more input devices <NUM> can include physically-actuatable user-interface elements (e.g., buttons, switches, or dials), touch screens, keyboards, mice, pens, and voice input devices, among others input devices.

The one or more output devices <NUM> are devices by which the computing system <NUM> can provide output to a user. The output devices <NUM> can include, displays, speakers, and printers, among other output devices.

As should be appreciated, while particular uses of the technology have been illustrated and discussed above, the disclosed technology can be used with a variety of devices in accordance with many examples of the technology. The above discussion is not meant to suggest that the disclosed technology is only suitable for implementation within systems akin to that illustrated in the figures. In general, additional configurations can be used to practice the processes and systems herein and/or some aspects described can be excluded without departing from the processes and systems disclosed herein.

This disclosure described some aspects of the present technology with reference to the accompanying drawings, in which only some of the possible aspects were shown. Other aspects can, however, be embodied in many different forms and should not be construed as limited to the aspects set forth herein. Rather, these aspects were provided so that this disclosure was thorough and complete and fully conveyed the scope of the possible aspects to those skilled in the art.

As should be appreciated, the various aspects (e.g., portions, components, etc.) described with respect to the figures herein are not intended to limit the systems and processes to the particular aspects described. Accordingly, additional configurations can be used to practice the methods and systems herein and/or some aspects described can be excluded without departing from the methods and systems disclosed herein.

Similarly, where steps of a process are disclosed, those steps are described for purposes of illustrating the present methods and systems and are not intended to limit the disclosure to a particular sequence of steps. For example, the steps can be performed in differing order, two or more steps can be performed concurrently, additional steps can be performed, and disclosed steps can be excluded without departing from the present disclosure. Further, the disclosed processes can be repeated.

Claim 1:
A system comprising:
an auditory prosthesis (<NUM>) configured to provide stimulation to a recipient to cause auditory percepts based on a current map; and
one or more processors (<NUM>) configured to:
receive (<NUM>) an indication from the recipient regarding a quality of stimulation; modify (<NUM>) the current map (<NUM>) based on the quality of stimulation;
determining (<NUM>) a difference between the modified current map (<NUM>) and a target map (<NUM>); and
responsive the difference failing to satisfy a threshold, generate (<NUM>) a clinician event.