Vivosonic at AAA 2019

Posted on March 11, 2019 by Vivosonic

Visit our booth (#1507) at the upcoming AAA Annual Meeting on March 27 to 30 in Columbus, Ohio. See the newest features of our Integrity™ V500 and view a demonstration.

Register for our education session:

EC201: ABR Newborn Hearing Screening:

Critical Issues Overlooked and Their Clinical Impact

Thursday, March 28, 2019

11:30 AM – 12:30 PM

Room: Union Station A

Aaron Steinman, PhD, P.Eng – Vice President Research, Vivosonic Inc. (Lead Presenter)

Instructional Level

Intermediate

Learning Objectives

Identify stimulus protocols and data collection strategies that will impact desired screening outcome.
Identify the trade-off between screening time and reliability of outcome.
Identify how different stimulus parameters with a common intensity yield different results

Session Category

Pediatrics (P)

Abstract

Many current ABR screeners are stimulating at more than double the rate, are using different stimulus types (i. e. wideband chirp, ASSR) and different montages than what was originally envisioned in the early guidelines, resulting in significant reduction of test time and potentially fewer refers. Although advantageous to the screening and diagnostics community, are these new techniques screening for the same previously targeted hearing loss? This presentation will summarize investigations into the effect of stimulus rate, stimulus type, and montage.

SUMMARY

Rationale
Many current ABR screeners can stimulate at more than double the rates, are using different stimulus types (i. e. wideband chirp, ASSR), and recommend different montages than what were originally envisioned in the original guidelines. This had led to significant reduction of test time and potentially fewer refers, which is advantageous to the screening and diagnostics community. However, are these new techniques screening for the same targeted hearing loss as the initial generation of equipment and protocols?

Objectives
This presentation will summarize investigations into the effect of stimulus rate, stimulus type and montage on screening

Design
Data collected from newborns as per standard ABR infant hearing and collected with different stimuli. Data was collected simultaneously from the nape and mastoid montages for comparison. Data was collected for both stimulus absent and stimulus present conditions. Stimulus present: click and chirp at regular and fast stimulus rates.

Results/Discussion
Stimulus absent results are used to determination of the sensitivity of the screener, as no stimulus absent result should have a screening pass result. It has been shown in previous research that screening with a 35 dB nHL click at 37. 7 Hz does not produce the same pass/refer as a 35 dB nHL chirp at 90 Hz.

Questions that will be raised and discussed:
– Can this result in missing a mild to moderate hearing loss that previously would have been detected?
– Is this an issue arising from stimulus rate or stimulus type differences?
– How do the signal processing algorithms need to be modified to account for different stimulus rates?
– If the dB eHL of a click is different than that of a chirp, would the difference in performance between a 35 dB nHL click and a 35 dB nHL chirp arise from the differences in dB eHL?

The preparation of a baby with a mastoid montage (2 channel electrode placement on the mastoid) is simpler than using a nape montage (1 channel electrode placement on the nape), especially since the baby is less likely to wake up (and make noise) in the preparation process.

Questions that will be raised and discussed:
– What is the impact on stimulus absent data when using a mastoid montage?
– How can loss to follow-up be eliminated – is it possible to seamlessly transition from screening to diagnostics while the infant is still connected to the system?

Vivosonic at AAA 2019