ARCHETYPE Behavioural observation audiometry (BOA) result (openEHR-EHR-OBSERVATION.behavioural_observation_audiometry_result.v0)

ARCHETYPE IDopenEHR-EHR-OBSERVATION.behavioural_observation_audiometry_result.v0
ConceptBehavioural observation audiometry (BOA) result
DescriptionObservations of an infant or young child’s unconditioned response to sound, and associated clinical interpretation.
Use

Use to record child’s Minimum Response Levels (MRL’s) and reflexive responses (eg. APR) to noisemakers and speech. Recorded in the free-field measuring a binaural response.

Use to record an overall interpretation of response levels and response qualities to provide an indication of the probable hearing status.
BOA is generally used as a secondary testing technique in infants under 6mo to provide supporting information to objective measures of hearing levels (ABR/SSEP). In cases where an infant cannot be conditioned to VROA, is not developmentally able to perform VROA, or if VROA equipment is unavailable, BOA may be used to obtain information about behavioural hearing.

Please note:

  • MRL: the lowest intensity level at which a response to a stimulus is recorded. An ascending technique should be used when establishing MRL’s.
  • dBA: Decibels measured in the sound field using the A scale sound level filter. Using this filter, the sound level meter is thus less sensitive to very high and very low frequencies

Details about assisted hearing devices used as aids in this test should be recorded in the EVALUATION.assisted_hearing_summary.

Misuse

Not to be used to record hearing threshold levels (HTL’s)

Not to be used to record any other assessments such as:

  • VROA;
  • PTA;
  • Play; and
  • Objective Assessments.
PurposeTo record unconditioned responses of an infant or young child’s response to auditory stimuli. To record the interpretation of responses.
ReferencesDerived from: Behavioural observation audiometry (BOA) result, Draft archetype [Internet]. Australian Digital Health Agency (NEHTA), ADHA Clinical Knowledge Manager. Authored: 2013. Available at: http://dcm.nehta.org.au/ckm#showArchetype_1013.1.1390_1 (discontinued).
Copyright© Northern Territory Department of Health (Australia), openEHR Foundation
AuthorsAuthor name: Jade Frederiksen
Organisation: Hearing Health Program, Northern Territory
Date originally authored: 2013
Other Details LanguageAuthor name: Jade Frederiksen
Organisation: Hearing Health Program, Northern Territory
Date originally authored: 2013
Other Details (Language Independent)
  • 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: Behavioural observation audiometry (BOA) result, Draft archetype [Internet]. Australian Digital Health Agency (NEHTA), ADHA Clinical Knowledge Manager. Authored: 2013. Available at: http://dcm.nehta.org.au/ckm#showArchetype_1013.1.1390_1 (discontinued).
  • Current Contact: Heather Leslie, Atomica Informatics, Australia
  • Original Namespace: org.openehr
  • Original Publisher: openEHR Foundation
  • Custodian Namespace: org.openehr
  • MD5-CAM-1.0.1: 041F71742BAA4879D1E697D2E05FE4B4
  • Build Uid: c5fc6fe0-e14c-48fb-b247-def1b5ab9cd1
  • Revision: 0.0.1-alpha
Keywordshearing, test, audiometry, MRL, decibels, observation, infant, boa
Lifecyclein_development
UID573380d6-70b1-4af3-98e9-8fc34203bd2a
Language useden
Citeable Identifier1246.145.2728
Revision Number0.0.1-alpha
protocol
ExtensionExtension: Additional information required to capture local content or to align with other reference models/formalisms.
For example: local information requirements or additional metadata to align with FHIR or CIMI equivalents.
Include:
All not explicitly excluded archetypes
Air presentationAir presentation: Presentation of the air conduction test stimulus indirectly to the inner ear through the atmosphere, via the auditory canal and middle ear structures.
  • 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.]
Test environmentTest environment: The environment in which the test is administered.
  • Audiometric booth [Sound-treated test environment that meets audiometric standards for ambient noise.]
  • Non-sound treated room [Test environment that does not meet audiometric standards for ambient noise.]
Background noiseBackground noise: The amount and nature of noise in the environment that may influence the test results.
If testing is conducted in an audiometric booth, this data element is redundant.
  • Clinically significant [The background noise may compromise test results.]
  • Not clinically significant [The background noise is not likely to compromise test results.]
Calibration reference dBCalibration reference dB: Scale used for acoustic calibration of the test signal.
  • dB SPL [The test stimuli are calibrated using the sound pressure level scale.]
  • dB HL [The test stimuli are calibrated using the hearing level scale.]
  • dB A [The test stimuli are calibrated using the A-weighted scale.]
ReliabilityReliability: Narrative description of the reliability of the response, as determined by the tester.
state
Response stateResponse state: The response state of the child during the test.
  • Light sleep [The child was lightly sleeping.]
  • Quiet and alert [The child was awake, quiet and alert.]
  • Crying [The child was crying.]
Confounding factorsConfounding factors: Narrative description of factors, not recorded elsewhere, that may influence the response results.
data
Result detailsResult details: The test result observations and interpretations.
StimulusStimulus: The type of stimulus used in the test.
The frequency or range of frequency used by each stimulus will need to be managed in a clinical system. In most situations as a stimulus is selected by the clinician, the relevant frequency or range will be inserted into the 'Frequency' data element.
FrequencyFrequency: The frequency or range of frequency of the identified stimulus.
Choice of:
  •  Interval of Quantity
    Lower: Property: Frequency
    Units:
    • Hz
    • kHz

    Upper: Property: Frequency
    Units:
    • Hz
    • kHz

  •  Quantity
    Property: Frequency
    Units:
    • Hz
    • kHz
LatencyLatency: *
Minimum response levelMinimum response level: Lowest intensity at which a response to a stimulus is observed.
Property: Loudness
Units: dB
ResponseResponse: *
  • No response [*]
  • Arousal [Baby has heightened state of arousal in response to the stimulus.]
  • Stilling [Baby ceases current activity.]
  • Eye response [Eye widening, eye movement or eye turn.]
  • Head turn [Baby turns head in response to stimulus.]
  • Auropalpebral reflex [An involuntary blink of the eye caused by contraction of the orbicularis oculi muscle in response to loud sounds.]
  • Startle reflex [Moro reflex in response to stimulus.]
No test resultNo test result: No test result is available for the side stimulated.
Reason for no test resultReason for no test result: Reason why no result is available for the side stimulated.
Multimedia representationMultimedia representation: Digital image, video or diagram representing the test results.
Include:
openEHR-EHR-CLUSTER.multimedia.v1 and specialisations
Overall interpretationOverall interpretation: Overall clinical interpretation of the responses for both ears.
Exam not doneExam not done: Details to explicitly record that this examination was not performed.
Include:
openEHR-EHR-CLUSTER.exclusion_exam.v1 and specialisations
CommentComment: Additional narrative about the test responses, not captured in other fields.
events
Any point in time eventAny point in time event: Default, unspecified point in time event which may be explicitly defined in a template or at run-time.
Other contributorsRebecca Matthews, NT Hearing
Amarjit Anand, NT Hearing
Translators