Archetype : openEHR-EHR-OBSERVATION.audiology_speech_test_result

Modellbiblioteket openEHR Fork

Name

Audiology speech test result

Description

Record of results from an audiology speech test conducted for the purpose of assessing speech discrimination and speech recognition, and their clinical interpretation.

Keywords

speech audiology

Purpose

To record results from an audiology speech test conducted for the purpose of assessing speech discrimination and speech recognition, and their clinical interpretation.

Use

Use to record the results of audiology speech tests carried out to assess speech discrimination and speech recognition.

Use to record the clinical interpretation of audiology speech tests carried out to assess speech discrimination and speech recognition.

Misuse

Not to be used for audiology speech testing that is used for phonemic confusions analysis.

Not to be used to assess speech production.

Not to be used to record audiology speech tests where the presentaton level is not known - for example: unmonitored live voice.

References

Derived from: Audiology Speech Test Result, Draft archetype [Internet]. Australian Digital Health Agency (NEHTA), ADHA Clinical Knowledge Manager. Authored: 2013 Jan 13. Available at: http://dcm.nehta.org.au/ckm#showArchetype_1013.1.1174_3 (discontinued).

Taylor B. Predicting Real World Hearing Aid Benefit with Speech Audiometry: An Evidence-Based Review; 2007 May 07 [cited 2013 Feb 08]. Available from: http://www.audiologyonline.com/articles/predicting-real-world-hearing-aid-946.

Madel J, Flexer C. Pediatric Audiology: Diagnosis, Technology, and Management. Thieme Medical Publishers; 2008. Chapter 10, Evaluation of Speech Perception in Infants and Children, p89-105.

Gordon-Salant S. Age-related differences in speech recognition performance as a function of test format and paradigm. Ear Hear. 1987 Oct;8(5):277-82. PubMed PMID: 3678641.

Nilsson M, Soli S D, Sullivan, J A. Development of the Hearing In Noise Test for the measurement of speech reception thresholds in quiet and in noise. Acoust. Soc. Am. 95, 1085 (1994), DOI:10.1121/1.408469.

Archetype Id

openEHR-EHR-OBSERVATION.audiology_speech_test_result.v0

Licencing

This work is licensed under the Creative Commons Attribution-ShareAlike 3.0 License. To view a copy of this license, visit http://creativecommons.org/licenses/by-sa/3.0/.

Original Author

Kerrie Lee

Date Originally Authored

To record results from an audiology speech test conducted for the purpose of assessing speech discrimination and speech recognition, and their clinical interpretation.

Name	Card	Type	Description
Test result name	0..1	DV_TEXT	Identification of the audiology speech test performed. Comment For example: AB Word List; Paediatric Speech Intelligibility (PSI); NUCHIPS; HINT; and BKB Sentences.
Result details	0..1	CLUSTER	The test measurements and interpretations which can be recorded per ear, or for both ears simultaneously. CLUSTER
Test ear	0..1	DV_CODED_TEXT	The ear to which to the speech signal is presented. Constraint for DV_CODED_TEXT Left ear [The test stimuli were presented to the left ear only.] Right ear [The test stimuli were presented to the right ear only.] Binaural [The test stimuli were presented to both ears simultaneously in a soundfield.]
Presentation method	0..1	DV_CODED_TEXT	The method used to present the speech test stimulus. Comment For exampe: a visual stimulus can be used to test lip reading skills. Constraint for DV_CODED_TEXT Auditory test [An auditory stimulus is presented to the test subject.] Audiovisual test [A combination of auditory and visual stimuli are presented to the test subject.] Visual test [A visual stimulus is presented to the test subject.]
Performance intensity function	0..*	CLUSTER	Results obtained for performance intensity function at each test level. CLUSTER
Loudness	0..1	DV_QUANTITY	The stimulus intensity. DV_QUANTITY
Words correct	0..1	DV_PROPORTION	Percentage of words to which the test subject responds correctly. DV_PROPORTION
Elements correct	0..1	DV_PROPORTION	Percentage of elements to which the test subject responds correctly. DV_PROPORTION
Adaptive speech test	0..1	CLUSTER	Details of the adaptive test protocol. CLUSTER
Loudness to achieve target	0..1	DV_QUANTITY	The mean dB loudness level of the speech stimuli required to achieve the target correct performance. DV_QUANTITY
Signal to noise ratio	0..1	DV_QUANTITY	The relationship of the loudness of the speech signal in dB to the loudness level of the noise stimulus. Comment For example: if the speech level is 50dB and the noise level in 60dB then the SNR is -10. DV_QUANTITY
Reliability	0..1	CLUSTER	Details about the responses correct of the subject being tested. CLUSTER
Standard error	0..1	DV_QUANTITY	A measure to compare a sample mean and a population mean. Comment This data element needs the properties of the quantity to be set to allow a decimal number. DV_QUANTITY
Confidence interval	0..1	DV_QUANTITY	A term used in inferential statistics that measures the probability that a population parameter will fall between two set values. DV_QUANTITY
Sample size	0..1	DV_COUNT	The number of reverals in an adaptive threshold test used for calculating estimates of a given test result.
No test result	0..1	DV_BOOLEAN	No test result is available for the test ear. Comment Record as True if the clinician was unable to record a result for the test ear or binaural testing in a soundfield, as defined by the 'Test Ear' data element. Constraint for DV_BOOLEAN
Reason for no test result	0..1	DV_TEXT	Reason why no result is available for the test ear. Comment For example, patient was not cooperative; patient was not capable; ran out of time.
Clinical interpretation	0..1	DV_TEXT	Clinical interpretation of all responses for the identified test ear.
Overall interpretation	0..1	DV_TEXT	Overall clinical interpretation of the responses for both ears.
Comment	0..1	DV_TEXT	Additional narrative about the test results and intepretation not captured in other fields.

Name	Card	Type	Description
Type of adaptive test	0..1	DV_CODED_TEXT	The type of adaptive test used. Typically either in quiet or in noise. Constraint for DV_CODED_TEXT Quiet [The speech signal is presented in optimal listening conditions, without any interference from other auditory signals.] Signal to noise ratio [The ratio of the signal intensity to the noise intensity.]
Target performance level	0..1	DV_PROPORTION	The specified percentage correct used to setup the adaptive test protocol. DV_PROPORTION
Start level	0..1	DV_QUANTITY	The initial presentation level in dB. DV_QUANTITY
Step size	0..1	DV_QUANTITY	The number of dB by which the stimullus intensity is changed after each response. DV_QUANTITY
Presentation voice	0..1	DV_CODED_TEXT	The mode by which the speech test stimuli are presented. Constraint for DV_CODED_TEXT Live voice [Presentation of the speech test stimuli by monitored live voice presentation by the tester.] Recorded voice [Presentation of the speech test stimuli from a recorded medium.]
Presentation method	0..1	DV_CODED_TEXT	The method used to present the speech test stimulus. Constraint for DV_CODED_TEXT Soundfield [The stimulus is presented via a loudspeaker located at least one metre away from the subject.] Insert earphone [The stimulus is presented via insert earphones.] Headphone [The stimulus is presented via external headphones - either circumaural or supraaural..]
Response type	0..1	DV_CODED_TEXT	The type of response the patient is asked to give after hearing each stimulus. Constraint for DV_CODED_TEXT Vocal [The person repeats the stimulus item that was heard.] Picture pointing [The test subject points to a picture of the stimulus item that was heard.] Written response alternatives [The test subject points to written text that corresponds to the stimulus item that was heard.] Concrete object pointing [The subject response is to point to a 3 dimensional (i.e., concrete) object.]
Response set	0..1	DV_CODED_TEXT	The size of the response set. Constraint for DV_CODED_TEXT Open set [The size of the response set is unlimited.] Closed set [The size of the response set is limited.] Closed task domain [The response set is limited and the response alternatives remain constant for the whole test list.]
Closed set alternatives	0..1	DV_COUNT	The number of response alternatives offered in the Closed Set.
Closed domain items	0..1	DV_COUNT	The number of response items offered in the Closed Task Domain.
Stimulus type	0..1	DV_CODED_TEXT	The type of speech stimulus used for the speech test. Constraint for DV_CODED_TEXT Nonsense syllable [A consonant-vowel (CV) or CCV or VC or VCC item that is not a real word but is phonotactically correct.] Nonsense CVC [Nonsense word comprising a consonant, then a vowel, then a final consonant, for example, "wub" or "yat".] Nonsense word [A speech stimulus that is not a real word but is phonotactically correct.] Monosyllabic word [A word comprised of a single syllable. For example, 'green'.] Spondee word [A word comprised of 2 syllables with equal stress on each syllable. For example, 'sunshine'.] Trochee word [A word that is comprised of two syllables with stress on the first syllable. For example 'bucket'.] Sentence [A grammatical unit of one or more words that expresses an independent statement, question, request, command, exclamation, etc.]
SNR speech presentation level	0..1	DV_QUANTITY	The initial signal to noise ratio level in dB. For example, +20 dB. DV_QUANTITY
SNR competing noise	0..1	DV_CODED_TEXT	Type of signal used as a competing signal during Signal to Noise Ratio testing. Constraint for DV_CODED_TEXT White noise [Noise that has the same power at all frequencies (i.e., a flat power spectrum).] Speech spectrum noise [Noise spectrum that approximates the average long term spectrum of adult male speech and has a slope below 100 Hz of +6 dB/octave, a flat spectrum between 100 Hz and 320 Hz, and above 320 Hz a slope of -6 dB/octave.] Multitalker babble [A recording of the voices of many people who are talking simultaneously, resulting in an unintelligible babble.] Alternate speaker [The masker is a single person speaking and this speaker is different to the speaker used for the test stimulus.]
SNR competing noise presentation	0..1	DV_CODED_TEXT	The type of noise used in a speech test measuring speech perception in noise. Constraint for DV_CODED_TEXT Ipsilateral [The noise is presented to the same ear as the speech signal.] Contralateral [The noise is presented to the ear opposite to the speech signal.]
Number of voices	0..1	DV_COUNT	Number of voices used to generate multispeaker babble. Comment Relevant only if 'Speech Babble' is the selected value for the 'Type of Mask' data element.
Masking presentation method	0..1	DV_CODED_TEXT	The method used to present the constralateral masking test signal. Constraint for DV_CODED_TEXT Earphone [A device that converts electric signals to audible sound and fits over or in the ear.] Loudspeaker [A listening condition in which the listener is 1 metre from a loud speaker and hears sounds presented via the loud speaker.]
Masking stimulus level	0..1	DV_QUANTITY	The level of the contralateral masking speech spectrum noise in dB. DV_QUANTITY
Calibration reference dB	0..1	DV_CODED_TEXT	Scale used for acoustic calibration check. Constraint for DV_CODED_TEXT dB SPL [The sound pressure level scale was used.] dB HL [The hearing level scale was used.] dB A [The A-weighted decibels of the sound pressure level scale were used.]

archetype (adl_version=1.4; uid=58b4a651-f781-4406-972a-e66c50e3a309)
	openEHR-EHR-OBSERVATION.audiology_speech_test_result.v0

concept
	[at0000]	-- Audiology speech test result
language
	original_language = <[ISO_639-1::en]>
description
	original_author = <
		["name"] = <"Kerrie Lee">
		["email"] = <"kerrie.lee2@bigpond.com">
		["date"] = <"2013-01-13">
	>
	details = <
		["en"] = <
			language = <[ISO_639-1::en]>
			purpose = <"To record results from an audiology speech test conducted for the purpose of assessing speech discrimination and speech recognition, and their clinical interpretation.">
			use = <"Use to record the results of audiology speech tests carried out to assess speech discrimination and speech recognition. 

Use to record the clinical interpretation of audiology speech tests carried out to assess speech discrimination and speech recognition.">
			keywords = <"speech", "audiology">
			misuse = <"Not to be used for audiology speech testing that is used for phonemic confusions analysis.

Not to be used to assess speech production.

Not to be used to record audiology speech tests where the presentaton level is not known - for example: unmonitored live voice.">
			copyright = <"© Northern Territory Department of Health (Australia), openEHR Foundation">
		>
	>
	lifecycle_state = <"in_development">
	other_contributors = <"Stephen Chu, NEHTA, Australia", "Kathy Currie, Northern Territory Health, Australia", "Sam Heard, Ocean Informatics, Australia (Editor)", "Anthony Leech, Hearing Health, Australia", "Kerrie Lee, Ngaanyatjarra Health Service, Australia", "Heather Leslie, Atomica Informatics, Australia (Editor)", "Ian McNicoll, Ocean Informatics UK, United Kingdom">
	other_details = <
		["licence"] = <"This work is licensed under the Creative Commons Attribution-ShareAlike 3.0 License. To view a copy of this license, visit http://creativecommons.org/licenses/by-sa/3.0/.">
		["custodian_organisation"] = <"openEHR Foundation">
		["references"] = <"Derived from: Audiology Speech Test Result, Draft archetype [Internet]. Australian Digital Health Agency (NEHTA), ADHA Clinical Knowledge Manager. Authored: 2013 Jan 13. Available at: http://dcm.nehta.org.au/ckm#showArchetype_1013.1.1174_3 (discontinued).

Taylor B. Predicting Real World Hearing Aid Benefit with Speech Audiometry: An Evidence-Based Review; 2007 May 07 [cited 2013 Feb 08]. Available from: http://www.audiologyonline.com/articles/predicting-real-world-hearing-aid-946.

Madel J, Flexer C. Pediatric Audiology: Diagnosis, Technology, and Management. Thieme Medical Publishers; 2008. Chapter 10, Evaluation of Speech Perception in Infants and Children, p89-105.

Gordon-Salant S. Age-related differences in speech recognition performance as a function of test format and paradigm. Ear Hear. 1987 Oct;8(5):277-82. PubMed PMID: 3678641. 

Nilsson M, Soli S D, Sullivan, J A. Development of the Hearing In Noise Test for the measurement of speech reception thresholds in quiet and in noise. Acoust. Soc. Am. 95, 1085 (1994), DOI:10.1121/1.408469.">
		["current_contact"] = <"Heather Leslie, Atomica Informatics, Australia<heather.leslie@atomicainformatics.com>">
		["original_namespace"] = <"org.openehr">
		["original_publisher"] = <"openEHR Foundation">
		["custodian_namespace"] = <"org.openehr">
		["MD5-CAM-1.0.1"] = <"9C9A58E6EF0D2BE2083B9B2356D7C04C">
		["build_uid"] = <"6294e6eb-4bb3-4dbc-a305-ff0e5ae6a0f5">
		["revision"] = <"0.0.1-alpha">
	>

definition
	OBSERVATION[at0000] matches {	-- Audiology speech test result
		data matches {
			HISTORY[at0001] matches {	-- Event Series
				events cardinality matches {1..*; unordered} matches {
					EVENT[at0002] occurrences matches {0..*} matches {	-- Any event
						data matches {
							ITEM_TREE[at0003] matches {	-- Tree
								items cardinality matches {0..*; unordered} matches {
									ELEMENT[at0004] occurrences matches {0..1} matches {	-- Test result name
										value matches {
											DV_TEXT matches {*}
										}
									}
									CLUSTER[at0005] occurrences matches {0..1} matches {	-- Result details
										items cardinality matches {1..*; unordered} matches {
											ELEMENT[at0006] occurrences matches {0..1} matches {	-- Test ear
												value matches {
													DV_CODED_TEXT matches {
														defining_code matches {
															[local::
															at0007, 	-- Left ear
															at0008, 	-- Right ear
															at0009]	-- Binaural
														}
													}
												}
											}
											ELEMENT[at0093] occurrences matches {0..1} matches {	-- Presentation method
												value matches {
													DV_CODED_TEXT matches {
														defining_code matches {
															[local::
															at0094, 	-- Auditory test
															at0095, 	-- Audiovisual test
															at0096]	-- Visual test
														}
													}
												}
											}
											CLUSTER[at0010] occurrences matches {0..*} matches {	-- Performance intensity function
												items cardinality matches {1..*; unordered} matches {
													ELEMENT[at0011] occurrences matches {0..1} matches {	-- Loudness
														value matches {
															C_DV_QUANTITY <
																property = <[openehr::123]>
																list = <
																	["1"] = <
																		units = <"dB">
																		precision = <|0|>
																	>
																>
															>
														}
													}
													ELEMENT[at0014] occurrences matches {0..1} matches {	-- Words correct
														value matches {
															DV_PROPORTION matches {
																numerator matches {|0.0..100.0|}
																type matches {2}
															}
														}
													}
													ELEMENT[at0015] occurrences matches {0..1} matches {	-- Elements correct
														value matches {
															DV_PROPORTION matches {
																numerator matches {|0.0..100.0|}
																is_integral matches {True}
																type matches {2}
															}
														}
													}
												}
											}
											CLUSTER[at0017] occurrences matches {0..1} matches {	-- Adaptive speech test
												items cardinality matches {1..*; unordered} matches {
													ELEMENT[at0018] occurrences matches {0..1} matches {	-- Loudness to achieve target
														value matches {
															C_DV_QUANTITY <
																property = <[openehr::123]>
																list = <
																	["1"] = <
																		units = <"dB">
																		precision = <|1|>
																	>
																>
															>
														}
													}
													ELEMENT[at0019] occurrences matches {0..1} matches {	-- Signal to noise ratio
														value matches {
															C_DV_QUANTITY <
																property = <[openehr::123]>
																list = <
																	["1"] = <
																		units = <"dB">
																		magnitude = <|-20.0..30.0|>
																		precision = <|0|>
																	>
																>
															>
														}
													}
													CLUSTER[at0013] occurrences matches {0..1} matches {	-- Reliability
														items cardinality matches {1; unordered} matches {
															ELEMENT[at0016] occurrences matches {0..1} matches {	-- Standard error
																value matches {
																	C_DV_QUANTITY <
																		property = <[openehr::118]>
																	>
																}
															}
															ELEMENT[at0078] occurrences matches {0..1} matches {	-- Confidence interval
																value matches {
																	C_DV_QUANTITY <
																		property = <[openehr::123]>
																		list = <
																			["1"] = <
																				units = <"dB">
																			>
																		>
																	>
																}
															}
															ELEMENT[at0081] occurrences matches {0..1} matches {	-- Sample size
																value matches {
																	DV_COUNT matches {*}
																}
															}
														}
													}
												}
											}
											ELEMENT[at0079] occurrences matches {0..1} matches {	-- No test result
												value matches {
													DV_BOOLEAN matches {
														value matches {True}
													}
												}
											}
											ELEMENT[at0080] occurrences matches {0..1} matches {	-- Reason for no test result
												value matches {
													DV_TEXT matches {*}
												}
											}
											ELEMENT[at0020] occurrences matches {0..1} matches {	-- Clinical interpretation
												value matches {
													DV_TEXT matches {*}
												}
											}
										}
									}
									ELEMENT[at0021] occurrences matches {0..1} matches {	-- Overall interpretation
										value matches {
											DV_TEXT matches {*}
										}
									}
									ELEMENT[at0022] occurrences matches {0..1} matches {	-- Comment
										value matches {
											DV_TEXT matches {*}
										}
									}
								}
							}
						}
						state matches {
							ITEM_TREE[at0023] matches {	-- Tree
								items cardinality matches {0..*; unordered} matches {
									ELEMENT[at0024] occurrences matches {0..1} matches {	-- Aided status
										value matches {
											DV_CODED_TEXT matches {
												defining_code matches {
													[local::
													at0025, 	-- Aided
													at0026]	-- Unaided
												}
											}
										}
									}
									ELEMENT[at0027] occurrences matches {0..1} matches {	-- Type of listening device
										value matches {
											DV_CODED_TEXT matches {
												defining_code matches {
													[local::
													at0028, 	-- Hearing aid
													at0029, 	-- Cochlear implant
													at0030]	-- Bone conductor aid
												}
											}
										}
									}
									ELEMENT[at0031] occurrences matches {0..1} matches {	-- Listening device settings
										value matches {
											DV_TEXT matches {*}
										}
									}
									allow_archetype CLUSTER[at0082] occurrences matches {0..*} matches {	-- Listening device
										include
											archetype_id/value matches {/openEHR-EHR-CLUSTER\.device(-[a-zA-Z0-9_]+)*\.v1/}
									}
									ELEMENT[at0033] occurrences matches {0..1} matches {	-- Contralateral masking
										value matches {
											DV_CODED_TEXT matches {
												defining_code matches {
													[local::
													at0034, 	-- Present
													at0035]	-- Absent
												}
											}
										}
									}
								}
							}
						}
					}
				}
			}
		}
		protocol matches {
			ITEM_TREE[at0032] matches {	-- Tree
				items cardinality matches {0..*; unordered} matches {
					ELEMENT[at0087] occurrences matches {0..1} matches {	-- Type of adaptive test
						value matches {
							DV_CODED_TEXT matches {
								defining_code matches {
									[local::
									at0088, 	-- Quiet
									at0089]	-- Signal to noise ratio
								}
							}
						}
					}
					ELEMENT[at0052] occurrences matches {0..1} matches {	-- Target performance level
						value matches {
							DV_PROPORTION matches {
								numerator matches {|0.0..100.0|}
								is_integral matches {False}
								type matches {2}
							}
						}
					}
					ELEMENT[at0091] occurrences matches {0..1} matches {	-- Start level
						value matches {
							C_DV_QUANTITY <
								property = <[openehr::123]>
								list = <
									["1"] = <
										units = <"dB">
										precision = <|0|>
									>
								>
							>
						}
					}
					ELEMENT[at0090] occurrences matches {0..1} matches {	-- Step size
						value matches {
							C_DV_QUANTITY <
								property = <[openehr::123]>
								list = <
									["1"] = <
										units = <"dB">
										precision = <|0|>
									>
								>
							>
						}
					}
					ELEMENT[at0054] occurrences matches {0..1} matches {	-- Presentation voice
						value matches {
							DV_CODED_TEXT matches {
								defining_code matches {
									[local::
									at0055, 	-- Live voice
									at0056]	-- Recorded voice
								}
							}
						}
					}
					ELEMENT[at0057] occurrences matches {0..1} matches {	-- Presentation method
						value matches {
							DV_CODED_TEXT matches {
								defining_code matches {
									[local::
									at0059, 	-- Soundfield
									at0098, 	-- Insert earphone
									at0058]	-- Headphone
								}
							}
						}
					}
					ELEMENT[at0060] occurrences matches {0..1} matches {	-- Response type
						value matches {
							DV_CODED_TEXT matches {
								defining_code matches {
									[local::
									at0061, 	-- Vocal
									at0062, 	-- Picture pointing
									at0063, 	-- Written response alternatives
									at0086]	-- Concrete object pointing
								}
							}
						}
					}
					ELEMENT[at0064] occurrences matches {0..1} matches {	-- Response set
						value matches {
							DV_CODED_TEXT matches {
								defining_code matches {
									[local::
									at0065, 	-- Open set
									at0066, 	-- Closed set
									at0067]	-- Closed task domain
								}
							}
						}
					}
					ELEMENT[at0068] occurrences matches {0..1} matches {	-- Closed set alternatives
						value matches {
							DV_COUNT matches {*}
						}
					}
					ELEMENT[at0069] occurrences matches {0..1} matches {	-- Closed domain items
						value matches {
							DV_COUNT matches {*}
						}
					}
					ELEMENT[at0070] occurrences matches {0..1} matches {	-- Stimulus type
						value matches {
							DV_CODED_TEXT matches {
								defining_code matches {
									[local::
									at0071, 	-- Nonsense syllable
									at0072, 	-- Nonsense CVC
									at0073, 	-- Nonsense word
									at0074, 	-- Monosyllabic word
									at0075, 	-- Spondee word
									at0076, 	-- Trochee word
									at0077]	-- Sentence
								}
							}
						}
					}
					ELEMENT[at0092] occurrences matches {0..1} matches {	-- SNR speech presentation level
						value matches {
							C_DV_QUANTITY <
								property = <[openehr::123]>
								list = <
									["1"] = <
										units = <"dB">
										precision = <|0|>
									>
								>
							>
						}
					}
					ELEMENT[at0040] occurrences matches {0..1} matches {	-- SNR competing noise
						value matches {
							DV_CODED_TEXT matches {
								defining_code matches {
									[local::
									at0041, 	-- White noise
									at0042, 	-- Speech spectrum noise
									at0043, 	-- Multitalker babble
									at0044]	-- Alternate speaker
								}
							}
						}
					}
					ELEMENT[at0083] occurrences matches {0..1} matches {	-- SNR competing noise presentation
						value matches {
							DV_CODED_TEXT matches {
								defining_code matches {
									[local::
									at0084, 	-- Ipsilateral
									at0085]	-- Contralateral
								}
							}
						}
					}
					ELEMENT[at0045] occurrences matches {0..1} matches {	-- Number of voices
						value matches {
							DV_COUNT matches {*}
						}
					}
					ELEMENT[at0036] occurrences matches {0..1} matches {	-- Masking presentation method
						value matches {
							DV_CODED_TEXT matches {
								defining_code matches {
									[local::
									at0037, 	-- Earphone
									at0038]	-- Loudspeaker
								}
							}
						}
					}
					ELEMENT[at0039] occurrences matches {0..1} matches {	-- Masking stimulus level
						value matches {
							C_DV_QUANTITY <
								property = <[openehr::123]>
								list = <
									["1"] = <
										units = <"dB">
									>
								>
							>
						}
					}
					ELEMENT[at0046] occurrences matches {0..1} matches {	-- Calibration reference dB
						value matches {
							DV_CODED_TEXT matches {
								defining_code matches {
									[local::
									at0047, 	-- dB SPL
									at0048, 	-- dB HL
									at0097]	-- dB A
								}
							}
						}
					}
				}
			}
		}
	}


ontology
	term_definitions = <
		["en"] = <
			items = <
				["at0000"] = <
					text = <"Audiology speech test result">
					description = <"Record of results from an audiology speech test conducted for the purpose of assessing speech discrimination and speech recognition, and their clinical interpretation.">
				>
				["at0001"] = <
					text = <"Event Series">
					description = <"@ internal @">
				>
				["at0002"] = <
					text = <"Any event">
					description = <"Default, unspecified point in time or interval event which may be explicitly defined in a template or at run-time.">
				>
				["at0003"] = <
					text = <"Tree">
					description = <"@ internal @">
				>
				["at0004"] = <
					text = <"Test result name">
					description = <"Identification of the audiology speech test performed.">
					comment = <"For example: AB Word List; Paediatric Speech Intelligibility (PSI);  NUCHIPS; HINT; and BKB Sentences.">
				>
				["at0005"] = <
					text = <"Result details">
					description = <"The test measurements and interpretations which can be recorded per ear, or for both ears simultaneously.">
				>
				["at0006"] = <
					text = <"Test ear">
					description = <"The ear to which to the speech signal is presented.">
				>
				["at0007"] = <
					text = <"Left ear">
					description = <"The test stimuli were presented to the left ear only.">
				>
				["at0008"] = <
					text = <"Right ear">
					description = <"The test stimuli were presented to the right ear only.">
				>
				["at0009"] = <
					text = <"Binaural">
					description = <"The test stimuli were presented to both ears simultaneously in a soundfield.">
				>
				["at0010"] = <
					text = <"Performance intensity function">
					description = <"Results obtained for performance intensity function at each test level.">
				>
				["at0011"] = <
					text = <"Loudness">
					description = <"The stimulus intensity.">
				>
				["at0013"] = <
					text = <"Reliability">
					description = <"Details about the responses correct of the subject being tested.">
				>
				["at0014"] = <
					text = <"Words correct">
					description = <"Percentage of words to which the test subject responds correctly.">
				>
				["at0015"] = <
					text = <"Elements correct">
					description = <"Percentage of elements to which the test subject responds correctly.">
				>
				["at0016"] = <
					text = <"Standard error">
					description = <"A measure to compare a sample mean and a population mean.">
					comment = <"This data element needs the properties of the quantity to be set to allow a decimal number.">
				>
				["at0017"] = <
					text = <"Adaptive speech test">
					description = <"Details of the adaptive test protocol.">
				>
				["at0018"] = <
					text = <"Loudness to achieve target">
					description = <"The mean dB loudness level of the speech stimuli required to achieve the target correct performance.">
				>
				["at0019"] = <
					text = <"Signal to noise ratio">
					description = <"The relationship of the loudness of the speech signal in dB to the loudness level of the noise stimulus.">
					comment = <"For example: if the speech level is 50dB and the noise level in 60dB then the SNR is -10.">
				>
				["at0020"] = <
					text = <"Clinical interpretation">
					description = <"Clinical interpretation of all responses for the identified test ear.">
				>
				["at0021"] = <
					text = <"Overall interpretation">
					description = <"Overall clinical interpretation of the responses for both ears.">
				>
				["at0022"] = <
					text = <"Comment">
					description = <"Additional narrative about the test results and intepretation not captured in other fields.">
				>
				["at0023"] = <
					text = <"Tree">
					description = <"@ internal @">
				>
				["at0024"] = <
					text = <"Aided status">
					description = <"Indication regarding use of an assistive listening device by the test subject during the test.">
				>
				["at0025"] = <
					text = <"Aided">
					description = <"The test has been conducted with the patient using a form of auditory assistance, such as a hearing aid or cochlear implant.">
				>
				["at0026"] = <
					text = <"Unaided">
					description = <"The test has been conducted without the patient using any form of auditory assistance, such as a hearing aid or cochlear implant.">
				>
				["at0027"] = <
					text = <"Type of listening device">
					description = <"Identification of type of assistive listening device used.">
					comment = <"Only relevant if 'Aid Status' value is 'Aided'.">
				>
				["at0028"] = <
					text = <"Hearing aid">
					description = <"A type of hearing device.">
				>
				["at0029"] = <
					text = <"Cochlear implant">
					description = <"A type of hearing device.">
				>
				["at0030"] = <
					text = <"Bone conductor aid">
					description = <"A type of hearing device.">
				>
				["at0031"] = <
					text = <"Listening device settings">
					description = <"Narrative description of the details of the assistive listening device settings.">
				>
				["at0032"] = <
					text = <"Tree">
					description = <"@ internal @">
				>
				["at0033"] = <
					text = <"Contralateral masking">
					description = <"Contralateral masking signal was presented to the non test ear.">
				>
				["at0034"] = <
					text = <"Present">
					description = <"Masking noise is presented to the non test ear.">
				>
				["at0035"] = <
					text = <"Absent">
					description = <"No masking noise is presented.">
				>
				["at0036"] = <
					text = <"Masking presentation method">
					description = <"The method used to present the constralateral masking test signal.">
				>
				["at0037"] = <
					text = <"Earphone">
					description = <"A device that converts electric signals to audible sound and fits over or in the ear.">
				>
				["at0038"] = <
					text = <"Loudspeaker">
					description = <"A listening condition in which the listener is 1 metre from a loud speaker and hears sounds presented via the loud speaker.">
				>
				["at0039"] = <
					text = <"Masking stimulus level">
					description = <"The level of the contralateral masking speech spectrum noise in dB.">
				>
				["at0040"] = <
					text = <"SNR competing noise">
					description = <"Type of signal used as a competing signal during Signal to Noise Ratio testing.">
				>
				["at0041"] = <
					text = <"White noise">
					description = <"Noise that has the same power at all frequencies (i.e., a flat power spectrum).">
				>
				["at0042"] = <
					text = <"Speech spectrum noise">
					description = <"Noise spectrum that approximates the average long term spectrum of adult male speech and has a slope below 100 Hz of +6 dB/octave, a flat spectrum between 100 Hz and 320 Hz, and above 320 Hz a slope of -6 dB/octave.">
				>
				["at0043"] = <
					text = <"Multitalker babble">
					description = <"A recording of the voices of many people who are talking simultaneously, resulting in an unintelligible babble.">
				>
				["at0044"] = <
					text = <"Alternate speaker">
					description = <"The masker is a single person speaking and this speaker is different to the speaker used for the test stimulus.">
				>
				["at0045"] = <
					text = <"Number of voices">
					description = <"Number of voices used to generate multispeaker babble.">
					comment = <"Relevant only if 'Speech Babble' is the selected value for the 'Type of Mask' data element.">
				>
				["at0046"] = <
					text = <"Calibration reference dB">
					description = <"Scale used for acoustic calibration check.">
				>
				["at0047"] = <
					text = <"dB SPL">
					description = <"The sound pressure level scale was used.">
				>
				["at0048"] = <
					text = <"dB HL">
					description = <"The hearing level scale was used.">
				>
				["at0052"] = <
					text = <"Target performance level">
					description = <"The specified percentage correct used to setup the adaptive test protocol.">
				>
				["at0054"] = <
					text = <"Presentation voice">
					description = <"The mode by which the speech test stimuli are presented.">
				>
				["at0055"] = <
					text = <"Live voice">
					description = <"Presentation of the speech test stimuli by monitored live voice presentation by the tester.">
				>
				["at0056"] = <
					text = <"Recorded voice">
					description = <"Presentation of the speech test stimuli from a recorded medium.">
				>
				["at0057"] = <
					text = <"Presentation method">
					description = <"The method used to present the speech test stimulus.">
				>
				["at0058"] = <
					text = <"Headphone">
					description = <"The stimulus is presented via external headphones - either circumaural or supraaural..">
				>
				["at0059"] = <
					text = <"Soundfield">
					description = <"The stimulus is presented via a loudspeaker located at least one metre away from the subject.">
				>
				["at0060"] = <
					text = <"Response type">
					description = <"The type of response the patient is asked to give after hearing each stimulus.">
				>
				["at0061"] = <
					text = <"Vocal">
					description = <"The person repeats the stimulus item that was heard.">
				>
				["at0062"] = <
					text = <"Picture pointing">
					description = <"The test subject points to a picture of the stimulus item that was heard.">
				>
				["at0063"] = <
					text = <"Written response alternatives">
					description = <"The test subject points to written text that corresponds to the stimulus item that was heard.">
				>
				["at0064"] = <
					text = <"Response set">
					description = <"The size of the response set.">
				>
				["at0065"] = <
					text = <"Open set">
					description = <"The size of the response set is unlimited.">
				>
				["at0066"] = <
					text = <"Closed set">
					description = <"The size of the response set is limited.">
				>
				["at0067"] = <
					text = <"Closed task domain">
					description = <"The response set is limited and the response alternatives remain constant for the whole test list.">
				>
				["at0068"] = <
					text = <"Closed set alternatives">
					description = <"The number of response alternatives offered in the Closed Set.">
				>
				["at0069"] = <
					text = <"Closed domain items">
					description = <"The number of response items offered in the Closed Task Domain.">
				>
				["at0070"] = <
					text = <"Stimulus type">
					description = <"The type of speech stimulus used for the speech test.">
				>
				["at0071"] = <
					text = <"Nonsense syllable">
					description = <"A consonant-vowel (CV) or CCV or VC or VCC item that is not a real word but is phonotactically correct.">
				>
				["at0072"] = <
					text = <"Nonsense CVC">
					description = <"Nonsense word comprising a consonant, then a vowel, then a final consonant, for example, \"wub\" or \"yat\".">
				>
				["at0073"] = <
					text = <"Nonsense word">
					description = <"A speech stimulus that is not a real word but is phonotactically correct.">
				>
				["at0074"] = <
					text = <"Monosyllabic word">
					description = <"A word comprised of a single syllable. For example, 'green'.">
				>
				["at0075"] = <
					text = <"Spondee word">
					description = <"A word comprised of 2 syllables with equal stress on each syllable. For example, 'sunshine'.">
				>
				["at0076"] = <
					text = <"Trochee word">
					description = <"A word that is comprised of two syllables with stress on the first syllable. For example 'bucket'.">
				>
				["at0077"] = <
					text = <"Sentence">
					description = <"A grammatical unit of one or more words that expresses an independent statement, question, request, command, exclamation, etc.">
				>
				["at0078"] = <
					text = <"Confidence interval">
					description = <"A term used in inferential statistics that measures the probability that a population parameter will fall between two set values.">
				>
				["at0079"] = <
					text = <"No test result">
					description = <"No test result is available for the test ear.">
					comment = <"Record as True if the clinician was unable to record a result for the test ear or binaural testing in a soundfield, as defined by the 'Test Ear' data element.">
				>
				["at0080"] = <
					text = <"Reason for no test result">
					description = <"Reason why no result is available for the test ear.">
					comment = <"For example, patient was not cooperative; patient was not capable; ran out of time.">
				>
				["at0081"] = <
					text = <"Sample size">
					description = <"The number of reverals in an adaptive threshold test used for calculating estimates of a given test result.">
				>
				["at0082"] = <
					text = <"Listening device">
					description = <"Details about the specific assistive listening device used during the test.">
				>
				["at0083"] = <
					text = <"SNR competing noise presentation">
					description = <"The type of noise used in a speech test measuring speech perception in noise.">
				>
				["at0084"] = <
					text = <"Ipsilateral">
					description = <"The noise is presented to the same ear as the speech signal.">
				>
				["at0085"] = <
					text = <"Contralateral">
					description = <"The noise is presented to the ear opposite to the speech signal.">
				>
				["at0086"] = <
					text = <"Concrete object pointing">
					description = <"The subject response is to point to a 3 dimensional (i.e., concrete) object.">
				>
				["at0087"] = <
					text = <"Type of adaptive test">
					description = <"The type of adaptive test used. Typically either in quiet or in noise.">
				>
				["at0088"] = <
					text = <"Quiet">
					description = <"The speech signal is presented in optimal listening conditions, without any interference from other auditory signals.">
				>
				["at0089"] = <
					text = <"Signal to noise ratio">
					description = <"The ratio of the signal intensity to the noise intensity.">
				>
				["at0090"] = <
					text = <"Step size">
					description = <"The number of dB by which the stimullus intensity is changed after each response.">
				>
				["at0091"] = <
					text = <"Start level">
					description = <"The initial presentation level in dB.">
				>
				["at0092"] = <
					text = <"SNR speech presentation level">
					description = <"The initial signal to noise ratio level in dB. For example, +20 dB.">
				>
				["at0093"] = <
					text = <"Presentation method">
					description = <"The method used to present the speech test stimulus.">
					comment = <"For exampe: a visual stimulus can be used to test lip reading skills.">
				>
				["at0094"] = <
					text = <"Auditory test">
					description = <"An auditory stimulus is presented to the test subject.">
				>
				["at0095"] = <
					text = <"Audiovisual test">
					description = <"A combination of auditory and visual stimuli are presented to the test subject.">
				>
				["at0096"] = <
					text = <"Visual test">
					description = <"A visual stimulus is presented to the test subject.">
				>
				["at0097"] = <
					text = <"dB A">
					description = <"The A-weighted decibels of the sound pressure level scale were used.">
				>
				["at0098"] = <
					text = <"Insert earphone">
					description = <"The stimulus is presented via insert earphones.">
				>
			>
		>
	>