APSO - APSO - Current Standards

S3.1 Comprehensive Diagnostic Hearing Evaluation for Adult Patients

A comprehensive diagnostic hearing evaluation is comprised of valid and reliable assessments of auditory function necessary for differential diagnosis.
Communication with patients is conducted in a clear, empathetic manner consistent with the patient's communication mode, comprehension, and their health literacy level. Audiologists encourage involvement of communication partners (e.g., family members, significant others, companions) whenever possible and appropriate.
A thorough patient history is obtained as part of the evaluation.
Visual inspection of the outer ear, ear canal, and eardrum are performed.
Pure tone air conduction thresholds are obtained at a minimum of octave frequencies, 250 Hz – 8000 Hz. Thresholds are obtained at interoctave frequencies when there is a 20 dB or greater difference between octave thresholds or as otherwise deemed necessary by the audiologist.
Pure tone bone conduction thresholds are obtained at octave frequencies 500 Hz – 4000 Hz to identify conductive, sensorineural, or mixed hearing loss. Thresholds are obtained at other octave and interoctave frequencies as deemed necessary by the audiologist.
Speech recognition thresholds or speech awareness thresholds are obtained using recorded stimuli to assess agreement with pure tone findings.
A measure of speech recognition ability is obtained using recorded stimuli at a presentation level that is expected to approximate the patient’s maximum performance. Audiologists perform speech recognition in noise to assess functional capacity.
Acoustic immittance of the external/middle ear is measured to support differential diagnosis. A tympanogram is obtained for each ear. When indicated by the patient’s history and audiometric findings, acoustic reflex thresholds are measured ipsilaterally and/or contralaterally.
Results and recommendations are communicated to the patient.
Written documentation of the diagnostic hearing evaluation is maintained as part of the patient record.

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