CA1267976A - Assess system - Google Patents
Assess systemInfo
- Publication number
- CA1267976A CA1267976A CA000521869A CA521869A CA1267976A CA 1267976 A CA1267976 A CA 1267976A CA 000521869 A CA000521869 A CA 000521869A CA 521869 A CA521869 A CA 521869A CA 1267976 A CA1267976 A CA 1267976A
- Authority
- CA
- Canada
- Prior art keywords
- test
- stimuli
- processor
- patient
- host controller
- Prior art date
- Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
- Expired - Lifetime
Links
Classifications
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/16—Devices for psychotechnics; Testing reaction times ; Devices for evaluating the psychological state
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B5/00—Measuring for diagnostic purposes; Identification of persons
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/103—Detecting, measuring or recording devices for testing the shape, pattern, colour, size or movement of the body or parts thereof, for diagnostic purposes
- A61B5/11—Measuring movement of the entire body or parts thereof, e.g. head or hand tremor, mobility of a limb
- A61B5/1104—Measuring movement of the entire body or parts thereof, e.g. head or hand tremor, mobility of a limb induced by stimuli or drugs
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/12—Audiometering
- A61B5/121—Audiometering evaluating hearing capacity
Abstract
ABSTRACT OF THE DISCLOSURE
An automated multi-purpose, real-time apparatus is provided herein for administration of visual and/or auditory stimuli to a patient. The apparatus includes a visual and/or auditory stimulus generator, a response acquisition system, a data display system and a host controller/processor system with memory and mass storage capability. A stimulus generator including auditory and/or visual stimulus generation means is used to present calibrated, predetermined sequences of test stimuli to the subject/patient under control of the host controller/processor.
Both test stimuli and test instructions may be presented using the stimulus generator. Various behaviourial responses from the subject are registered and relayed to the host controller/pro-cessor. The apparatus also includes an operator control terminal by which data entry and editing are provided for programming the host controller/processor. The results obtained from the administration of individual tests and test batteries are analyzed and stored and a database archive of patient files may then be updated. Various summaries of test results are reported and communicated, and may be displayed through reference to the database archive.
An automated multi-purpose, real-time apparatus is provided herein for administration of visual and/or auditory stimuli to a patient. The apparatus includes a visual and/or auditory stimulus generator, a response acquisition system, a data display system and a host controller/processor system with memory and mass storage capability. A stimulus generator including auditory and/or visual stimulus generation means is used to present calibrated, predetermined sequences of test stimuli to the subject/patient under control of the host controller/processor.
Both test stimuli and test instructions may be presented using the stimulus generator. Various behaviourial responses from the subject are registered and relayed to the host controller/pro-cessor. The apparatus also includes an operator control terminal by which data entry and editing are provided for programming the host controller/processor. The results obtained from the administration of individual tests and test batteries are analyzed and stored and a database archive of patient files may then be updated. Various summaries of test results are reported and communicated, and may be displayed through reference to the database archive.
Description
~2~i79~
This invention relates to apparatus and method for providing and administering at least one of visual and auditory tests to observers to assess at least one of their visual, auditory, cognitive and attentional performance capability.
Humans are able to process information about their environment through the senses of vision an~ hearing. Although vision and hearing senses are concerned with transduction of ; variations in photic and acoustic energy radiated or reflected from surrounding objects into nervous impulses, they also include the neural mechanisms used in the coding, transmission, storage and association of sensory signals within the nervous system.
Important in every aspect of life and strongly represented in the experiences, descriptions and concerns o the individual, vision and auditory functions receive much attention in health care services.
Abnormalities of visual, auditory, cognitive and attentional function can indicate the presence of a variety of diseases and disorders. As a considerable portion of the human brain is devoted to vision and hearing, and as the neural mechanisms mediating vision and hearing are distributed throughout the brain, disorders that afect brain structure and function will often affect vision and/or hearing function either directly or indirectly. Conse~uently, information regarding visual and auditory function is useful to the medical diagnostician.
'~, 2679~
The visual and auditory sensory modalities are efficient information channels and are, -therefore, also an important means for providing input for the evaluation of certain aspects of cognition and attentional capabilities. Rapid and noninvasive î evaluation of visual, auditory, cognitive and attentional performance are also desirable in many non-medical applications, for example, in the screening of individuals who may be either especially well suited or especially poorly suited for tasks requiring a given degree of visual, auditory, cognitive or attentional capacity. As these capacities are known to change with changes in the level of fatigue, arousal and the number of other tasks requir~d of the subject at the same time, it is important to be able to evaluate these capabilities under conditions where these variables are controlled.
Automation of visual, auditory, cognitive and attentional tests can greatly increase the efficiency of test administration through increasing test speed, patient comfort and data quality.
Test automation also oEfers the promise of decreased cost, including savings in operational time and space requirements.
Two basis types of tests are used: psychophysical tests (where behavioral responses are obtained), and stimulus-evoked electrophysiological tests (where electrical responses from the brain are recorded that are believed to reflect specific sensory, cognitive or attentional capabilities). Phychophysical tests have the advantages o~ relative technical simplicity, non-:~
, :~679~76 invasiveness and accuracy. Some of the most venerable diagnostica]ly useful tests are psychophysical tests of sensory function. Among these are the determination of visual activity, colour vision, parametric analysis of visual fields, dark adaptation; of determining auditory function, including absolute and di ferential audiometry, masking speech recognition and localization. Many of these tests have shown to be of use in following the progression and remission of diseases as well as in estimating the amount of residual function after cerebrovascular accidents and trauma. They can also be used to provide objective evaluation of therapeutic interventions,e.g. drug treatments, etc. ~here are three areas of application of stimulus-evoked electrophysiological techniques that complement psychophysical methods, namely: (1) as an index of sensory processes not amenable to study through psychoph~sical means; (~) for more objective confirmation of psychophysical findings in patients who are, for whatever reason, difficult to test; and (3) for real-time monitoring of sensory status during surgery and therapy.
Although the past decade has shown the emergence of many devices for the analysis of electrical responses from the brain (and which concentrate mainly, upon the signal processing aspects of the recording technique), few automatic methods have been ~` deveIoped that generate stimuli, control stimulus presentation, collect subject responses and store and manage the data obtained.
:~2~76 .i Canadian Patent No. 1,17~,359 of Ledley et al, issued September 11, 1984, describes an apparatus or a computerized electro-oculo~raphic system for automatic administration of electro-oculographic tests and visual evoked response tests to a patient, and automated processing of results derived from such tests. Automated administration of the tests is conducted either under the direct control of the test administrator via an operator control section or under the automated control of a programmed computer with indirect control by the test ~lO administrator. It should be noted that such apparatus, although providing automated administration of certain test stimuli to a patient via employment of an operator control console, does not have multi-purpose capability. It does not provide t- intelligence" in the system so as to allow optimization of the tests based on operator selection test batteries. Furthermore, it does not provide comparison capability of test results with normati~e data from a database.
herefore, it is an object of one broad aspect of the present invention to provide an automated multi-purpose, real-tlme base apparatus for test administration and or recording analysis of data in real-time, which also is capable of providing means to enable the test administrator to optimize test batteries.
Accordingly, by one broad aspect of the present i~vention, an interactive patient diagnostic system of the stimulus-response ~ILZ6~976 type is provided herein for evaluating aspects of at least one of visual, auditory, cognitive, and attentional performance and capacity of a subject, comprising: (a) a h~st computer; (b) a stimulus generator display means for presenting predetermined sequential input stimuli including at least one of visual stimuli and audi-tory stimuli to the subject, the stimuli being provlded by at least one selected stimuli-generating module in the host controller/processor; (c) subject response means for registering responses of the subject to the sequential input stimuli and for relaying the responses to the host controller/processor; ~d) data entry means for instructing the host controller/processor to provide the stimuli from the selected stimuli-generating module in a predetermined sequence; and ~e) and an analysis, storage and communication means interfaced with the host controller/processor to carry out the analysis of test data, the archival storage of recently acquired test data, the comparison with previously stored data and the reporting of test results.
In a specific embodiment of the apparatus of this invention, an automated multi-purpose real-time apparatus is provided for administration of stimuli to a patient, for evaluating perfor-mance levels of a selected at least one of visual, auditory, cognitive and attentional capacities of a patient, using a host/controller processor including memory and mass storage capabilities for storing data and instructions, -the apparatus comprising: (a) an operator station means having an input display , . , : : .... .
~Z67~76 means permitting an operator of the apparatus to select individual test parameters, individual tests or sequences of tests; (b) a patient ~tation means having a display means, an input means fox applying stimuli from a selected test to the patient, and a response means for the collection of patient responses to the applied stimuli ana for inputting the responses to the host controller/processor; (c~ a stimulus generator module at the operator station for providing the stimuli from a selected test and also for providing a real-time image generation means;
and (d) a test measurement module, resident in the host con-troller/processor, for providing a data capture means for cap-turing patient responses, for providing an update means for recording patient responses, and for providing a report means for providing test reports and patient optiMization feedback signals to the patient station means.
The analysis means should preferably înclude a data comparison means and a data storage means. The operator control means should preferably include means to start, to stop and to restart the test sequence for test optimization. The real-time image generation means should preferably include an interface means for interfacing an image storage means to the host con-troller/processor, most preferably in the form of a video disk storage device. The host controller/processor should preferably include interfacing means for inputti.ng electrode sensor input signals to the host controller/processor. The host controller/
~~~
~L~267976 processor interface means should preferably include an input means and a display means to enable the operator to provide parameter selection lnformation to the host controller/processor.
The means for applying stimuli from a selected test should preferably include both a visual stimulation test means, and an auditory stimulation test means.
The test measurement module pre~erably also includes an eye movement monitor means for recording eye position and movements.
The eye movement monitor preferably comprises an infra-red light source and an infra-red sensitive closed circuit television camera and automated eye movement data analysis means.
As mentioned above, the means for administering at least one of visual and auditory stimuli preferably includes both a visual stimulation test means, and an auditory stimulation test means.
Preferably, the visual stimulatlon test means may include a high intensity electric light source and a graphics display means for providing visual and colour stimuli testing signals a-t the patient station means. Preferably, the auditory stimulation test means may include an interface means for interfacing an auditory means with the host computer/processor for providing auditory stimuli testing signals.
In general terms, the apparatus includes visual and/or auditory stimuluY generation means, a response acquisition means, a data display means and host controller/processor means with memory and mass storage capability. Stimulus generation means !
1,~67976 includes auditory and~or visual ~timulus generation means is used to present calibrated, predetermined sequences of test stimuli to the subject/patient under control of the host controller/pro-cessor. Both test stimuli and test instructions may be presented using the stimulus generation means. Subject response means are provided for registering various behaviourial responses from the subject and for relaying these responses to the host controller/
processor. The apparatus also includes an operator control con-sole for by which data entry and editing means are provided for programming the host controller/processor. This provides the capability for modification of the specifics of individual test modules and for the assemblage of various selected test modules in a variety of predetermined sequences. A data analysis and archiving means is provided for analyzing and storing the results obtained from the administration of individual tests and test batteries and for updating a database archive of patient files.
Finally, a reporting and communications means is provided -to permit the display of various summaries of test results through reference to the database archive.
In the accompanying drawings, FIGURE 1 is a block diagram of a computerized, real-time visual and auditory stimulator and test apparatus according to one embodiment of the present invention showing its main logic control components;
FIGURE 2 is an overview of the system block diagram of the apparatus of EIGURE 1;
~Z67976 g PIGUR~ 3 is a system block diagram of the system development and training functions of FIGURE 2; and FIG~RE 4 is ~ system block diagram of the stimuli test function of FIGURE 2.
Turning first to Figure 1, a block diagram of the computerized te~t apparatu l2) according to one embodiment of the present invention is shownO The test apparatus t2~ consists of a host ccntroller/processor ~4) which is preferably, but is not necessarily limited to, a microprocessor, a test operator control station (6) which include~ a display t8) and a keyboard shown generally as (10) and a patient station (12), which also includes a display ~14), a keyboard ~9) for entering responses and for displaying test stimuli and instructions to a patient. A
printer tl9) is connected to the host controller/processor (~) for providing a hardcopy of a report as required. The stimu-lation subcomponent (22) provides an interface between the devices of the patient station ~12) and the hoit controller/pro-cessor ~4). A storage ~54) i5 connected to the host computer, the storage (54) including test files, depicted as blocks (70), (72), (74), (76) and (78). The real-time generation component (24) provides an interface between the image stage (26) and the stimulation subcomponent (22). The behaviourial response monitoring component ~28) provides an interface between the hand response component (30), the voice response component (32), the eye response component (34) and the host controller/processor (4).
~LZ67976 - ga -The host controller/processor ~4) provides the automation capability of the system. It is possible, within the ambit of this invention, to sequence a number of tests into test batteries to optimize time and space efficiency in the provision of clini-cal service and to increase the power of diagnostic procedures.
Through careful design of a number of test ~ ~ !
12~7~76 batteries, such that each one is specific to certain disease categories or diagnosis requirements, it will be possible to decrease total "worst case" patient testing to khat of a single testing session of less than two hours. ~ence, optimization of the test could be achieved.
Furthermore, a database management facility may be used to permit comparison of individual test results with normative data from the database, thereby to enhance the value of the test apparatus and method of the present invention.
Referring now in more detail to the system block diagram of Figures 2 and 3, upon starting up, the initializa-tion module (38) of the processor (4) initializes the system and passes control to log-on procedure module (40), which provides log-on request at the display (8) of the operator control station (6) in order to allow an operator to start the test session. Once the operator has completed the log-on procedure, the log-on procedure module (40) requests the operator to select system functions, e.g.
development function (46), operator training function (44) or test function (42).
The development function (46) allows modifications and/or enhancements to be added to the system, such that each system could be customized and optimized according to the requirement.
IE the development function (46) is selected, the log-on procedure module (40) passes control to the development function (46) which, in turn, passes control to the system development a~
module (4~). The system is then set for modifications and/or enhancement purposes. ~t the end of such system development, the system development module (~8) passes control to the end routine (68) which, in turn, returns the system back to the initialized stage.
The operator training function (44) provides training sessions for system operation. Such function is provided by the training module ~50). Upon termination of the training session, the training module (50) returns control to the end routine (68) which sets the system back to the initialized stage.
Referring now -to Figure 4, the test function (42) allows tests to be performed. Once the test function (42) is selected ;~ by the operator from the operator control station (6) by using the key~oard (10), the system passes control to the test manual module ~52) which displays further test selection and patient requests on the display (8) at the operator control station (6).
Having completed patient information from the keyboard (10), the ,. , operator can now select either an individual test function (56) or a battery test function (58).
In either case, the system will present further test parameter requests to the operator at the display (8) of the operator control station (6). Thèrefore, the operator can optimize the administration of the test facility by requesting certain parameters or by using default values, without compromising the tests. Furthermore, the system provides .
~Z~9~
interru~t capability to the operator so that tests can be quickly and easily aborted and restarted with the capability to continue from the stopping point of the test.
If the operator selects the individual test function (56), the system passes control to the single test administration module (64) such that the system raquests the operator to select the type of individual test available in the system. Each of these tests provides certain specifications of test parameters in a test file (70) located in storage (54). Each test has a ;10 "query" point where the operator can invoke the default test parameters contai~ed in the test file t70). Also, each test is associated with a stimulus graphics file (72), also located in storage (54). In addition, parameters for patient performance ~` optimization can be provided in test file (70) in order to provide feedback to the patient regarding test performance.
urthermore, each test is associated with an additional file, namely, a patient instruction file (74) which provides information on the display ~14) at the patient station (12) for the patient to carry out the test.
Once the operator has selected the type of test and has '~ provided patient data to the patient data file (62) (if he has selected the single test administration module (64)), or has passed through the test search module (60), (if he has selected the battery test (58)), the system passes control to the test administration module and file generator (66) whereby, based on ~26797~
the information in the test file (70), the stimulus module (76) sets up the proper test sequence by passing control to the appropriate routine. In the case of a visual test, the stimulus module (76) passes control to the visual test module (78) whlch will cause test patterns to be displayed at the display (14) of the patient station (12) and to provide instructions to the patient at the display (14) of the patient station (12). It may also provide audio instructions for visual tests and/or visual instructions for auditory tests. In the case of an auditory function test, the stimulus module (76) passes control to the auditory test module (80), whereby the auditory test module (80) causes test signals to be generated at headphones/speakers (36) of the patient station (12). In addition, the stimulus module (76) communicates with the response requisition module (84) to monitor the response from the patient.
The response requisition module (84) interfaces ~ith the response monitoring subcomponent (28) (see Figure 1) which includes hand response component (30), voice response component (3~) and eye response component (34). The responses are fed into the processor (4) and the data are analyzed by the data analysis module (86). In this way, test results and reports with appropriate graphics can be provided at the end of the test from the hardcopy printer (20) or can be displayed at the display (8) of the station (6) (see Figure 1). Furthermore, results communicated to the patient could also ~e used to provide ~2~i7976 performance feedback to the patient under test in order to optimize patient performance.
Finally, on the completion of the testing session, a message appears on the patient display (14) indicating that the session is complete. The patient data file is updated with the results of the analysis by the test database update module (88). A
~ printout of an interim report of the results of the test may ~e generated by the hardcopy generator module (90) and the system passes control back to the test administration module (68). The operator display (8) is set back to the test selection session.
As noted before, instead of selecting individual tests, the operator can select a test battery. In such a case, control is ~ passed to the test function battery module (58~ such that the ; operator can select a number of tests into the test batteries in order to optimi2e the use of time and space. Then the system passes control to the test search module (60) to set up the test files and parameters. The test search module (60) eventually passes control to the test administration module and file generator (56) and the test session a follows similar path to the 20 single test session from then on.
The image/audio data of the test patterns of all the test sessions are stored in the image storage module (26) which may be ;~ a video disk. It is understood that such device may be substituted by other devices without affecting the performance of the system.
.
1267g7~
Hence it can be seen that the present invention is capable of performing all the procedures common to at least one of visual and auditory tests, as the system provides the facility to set up the operator and patient instructions by the user.
Thus, it is apparent that, in accordance with broad concepts of this invention, a computerized test apparatus has been provided that fully satisfies the objects, aims and advantages set forth above. It will also be apparent to one skilled in the art that thè system may be modified to adapt to the operation of ; a different host controller/processor (4), e.g., a minicomputer or mainframm rompu~mr, or by using diffmrmnt mtoragm ~ans.
; ' ' .
This invention relates to apparatus and method for providing and administering at least one of visual and auditory tests to observers to assess at least one of their visual, auditory, cognitive and attentional performance capability.
Humans are able to process information about their environment through the senses of vision an~ hearing. Although vision and hearing senses are concerned with transduction of ; variations in photic and acoustic energy radiated or reflected from surrounding objects into nervous impulses, they also include the neural mechanisms used in the coding, transmission, storage and association of sensory signals within the nervous system.
Important in every aspect of life and strongly represented in the experiences, descriptions and concerns o the individual, vision and auditory functions receive much attention in health care services.
Abnormalities of visual, auditory, cognitive and attentional function can indicate the presence of a variety of diseases and disorders. As a considerable portion of the human brain is devoted to vision and hearing, and as the neural mechanisms mediating vision and hearing are distributed throughout the brain, disorders that afect brain structure and function will often affect vision and/or hearing function either directly or indirectly. Conse~uently, information regarding visual and auditory function is useful to the medical diagnostician.
'~, 2679~
The visual and auditory sensory modalities are efficient information channels and are, -therefore, also an important means for providing input for the evaluation of certain aspects of cognition and attentional capabilities. Rapid and noninvasive î evaluation of visual, auditory, cognitive and attentional performance are also desirable in many non-medical applications, for example, in the screening of individuals who may be either especially well suited or especially poorly suited for tasks requiring a given degree of visual, auditory, cognitive or attentional capacity. As these capacities are known to change with changes in the level of fatigue, arousal and the number of other tasks requir~d of the subject at the same time, it is important to be able to evaluate these capabilities under conditions where these variables are controlled.
Automation of visual, auditory, cognitive and attentional tests can greatly increase the efficiency of test administration through increasing test speed, patient comfort and data quality.
Test automation also oEfers the promise of decreased cost, including savings in operational time and space requirements.
Two basis types of tests are used: psychophysical tests (where behavioral responses are obtained), and stimulus-evoked electrophysiological tests (where electrical responses from the brain are recorded that are believed to reflect specific sensory, cognitive or attentional capabilities). Phychophysical tests have the advantages o~ relative technical simplicity, non-:~
, :~679~76 invasiveness and accuracy. Some of the most venerable diagnostica]ly useful tests are psychophysical tests of sensory function. Among these are the determination of visual activity, colour vision, parametric analysis of visual fields, dark adaptation; of determining auditory function, including absolute and di ferential audiometry, masking speech recognition and localization. Many of these tests have shown to be of use in following the progression and remission of diseases as well as in estimating the amount of residual function after cerebrovascular accidents and trauma. They can also be used to provide objective evaluation of therapeutic interventions,e.g. drug treatments, etc. ~here are three areas of application of stimulus-evoked electrophysiological techniques that complement psychophysical methods, namely: (1) as an index of sensory processes not amenable to study through psychoph~sical means; (~) for more objective confirmation of psychophysical findings in patients who are, for whatever reason, difficult to test; and (3) for real-time monitoring of sensory status during surgery and therapy.
Although the past decade has shown the emergence of many devices for the analysis of electrical responses from the brain (and which concentrate mainly, upon the signal processing aspects of the recording technique), few automatic methods have been ~` deveIoped that generate stimuli, control stimulus presentation, collect subject responses and store and manage the data obtained.
:~2~76 .i Canadian Patent No. 1,17~,359 of Ledley et al, issued September 11, 1984, describes an apparatus or a computerized electro-oculo~raphic system for automatic administration of electro-oculographic tests and visual evoked response tests to a patient, and automated processing of results derived from such tests. Automated administration of the tests is conducted either under the direct control of the test administrator via an operator control section or under the automated control of a programmed computer with indirect control by the test ~lO administrator. It should be noted that such apparatus, although providing automated administration of certain test stimuli to a patient via employment of an operator control console, does not have multi-purpose capability. It does not provide t- intelligence" in the system so as to allow optimization of the tests based on operator selection test batteries. Furthermore, it does not provide comparison capability of test results with normati~e data from a database.
herefore, it is an object of one broad aspect of the present invention to provide an automated multi-purpose, real-tlme base apparatus for test administration and or recording analysis of data in real-time, which also is capable of providing means to enable the test administrator to optimize test batteries.
Accordingly, by one broad aspect of the present i~vention, an interactive patient diagnostic system of the stimulus-response ~ILZ6~976 type is provided herein for evaluating aspects of at least one of visual, auditory, cognitive, and attentional performance and capacity of a subject, comprising: (a) a h~st computer; (b) a stimulus generator display means for presenting predetermined sequential input stimuli including at least one of visual stimuli and audi-tory stimuli to the subject, the stimuli being provlded by at least one selected stimuli-generating module in the host controller/processor; (c) subject response means for registering responses of the subject to the sequential input stimuli and for relaying the responses to the host controller/processor; ~d) data entry means for instructing the host controller/processor to provide the stimuli from the selected stimuli-generating module in a predetermined sequence; and ~e) and an analysis, storage and communication means interfaced with the host controller/processor to carry out the analysis of test data, the archival storage of recently acquired test data, the comparison with previously stored data and the reporting of test results.
In a specific embodiment of the apparatus of this invention, an automated multi-purpose real-time apparatus is provided for administration of stimuli to a patient, for evaluating perfor-mance levels of a selected at least one of visual, auditory, cognitive and attentional capacities of a patient, using a host/controller processor including memory and mass storage capabilities for storing data and instructions, -the apparatus comprising: (a) an operator station means having an input display , . , : : .... .
~Z67~76 means permitting an operator of the apparatus to select individual test parameters, individual tests or sequences of tests; (b) a patient ~tation means having a display means, an input means fox applying stimuli from a selected test to the patient, and a response means for the collection of patient responses to the applied stimuli ana for inputting the responses to the host controller/processor; (c~ a stimulus generator module at the operator station for providing the stimuli from a selected test and also for providing a real-time image generation means;
and (d) a test measurement module, resident in the host con-troller/processor, for providing a data capture means for cap-turing patient responses, for providing an update means for recording patient responses, and for providing a report means for providing test reports and patient optiMization feedback signals to the patient station means.
The analysis means should preferably înclude a data comparison means and a data storage means. The operator control means should preferably include means to start, to stop and to restart the test sequence for test optimization. The real-time image generation means should preferably include an interface means for interfacing an image storage means to the host con-troller/processor, most preferably in the form of a video disk storage device. The host controller/processor should preferably include interfacing means for inputti.ng electrode sensor input signals to the host controller/processor. The host controller/
~~~
~L~267976 processor interface means should preferably include an input means and a display means to enable the operator to provide parameter selection lnformation to the host controller/processor.
The means for applying stimuli from a selected test should preferably include both a visual stimulation test means, and an auditory stimulation test means.
The test measurement module pre~erably also includes an eye movement monitor means for recording eye position and movements.
The eye movement monitor preferably comprises an infra-red light source and an infra-red sensitive closed circuit television camera and automated eye movement data analysis means.
As mentioned above, the means for administering at least one of visual and auditory stimuli preferably includes both a visual stimulation test means, and an auditory stimulation test means.
Preferably, the visual stimulatlon test means may include a high intensity electric light source and a graphics display means for providing visual and colour stimuli testing signals a-t the patient station means. Preferably, the auditory stimulation test means may include an interface means for interfacing an auditory means with the host computer/processor for providing auditory stimuli testing signals.
In general terms, the apparatus includes visual and/or auditory stimuluY generation means, a response acquisition means, a data display means and host controller/processor means with memory and mass storage capability. Stimulus generation means !
1,~67976 includes auditory and~or visual ~timulus generation means is used to present calibrated, predetermined sequences of test stimuli to the subject/patient under control of the host controller/pro-cessor. Both test stimuli and test instructions may be presented using the stimulus generation means. Subject response means are provided for registering various behaviourial responses from the subject and for relaying these responses to the host controller/
processor. The apparatus also includes an operator control con-sole for by which data entry and editing means are provided for programming the host controller/processor. This provides the capability for modification of the specifics of individual test modules and for the assemblage of various selected test modules in a variety of predetermined sequences. A data analysis and archiving means is provided for analyzing and storing the results obtained from the administration of individual tests and test batteries and for updating a database archive of patient files.
Finally, a reporting and communications means is provided -to permit the display of various summaries of test results through reference to the database archive.
In the accompanying drawings, FIGURE 1 is a block diagram of a computerized, real-time visual and auditory stimulator and test apparatus according to one embodiment of the present invention showing its main logic control components;
FIGURE 2 is an overview of the system block diagram of the apparatus of EIGURE 1;
~Z67976 g PIGUR~ 3 is a system block diagram of the system development and training functions of FIGURE 2; and FIG~RE 4 is ~ system block diagram of the stimuli test function of FIGURE 2.
Turning first to Figure 1, a block diagram of the computerized te~t apparatu l2) according to one embodiment of the present invention is shownO The test apparatus t2~ consists of a host ccntroller/processor ~4) which is preferably, but is not necessarily limited to, a microprocessor, a test operator control station (6) which include~ a display t8) and a keyboard shown generally as (10) and a patient station (12), which also includes a display ~14), a keyboard ~9) for entering responses and for displaying test stimuli and instructions to a patient. A
printer tl9) is connected to the host controller/processor (~) for providing a hardcopy of a report as required. The stimu-lation subcomponent (22) provides an interface between the devices of the patient station ~12) and the hoit controller/pro-cessor ~4). A storage ~54) i5 connected to the host computer, the storage (54) including test files, depicted as blocks (70), (72), (74), (76) and (78). The real-time generation component (24) provides an interface between the image stage (26) and the stimulation subcomponent (22). The behaviourial response monitoring component ~28) provides an interface between the hand response component (30), the voice response component (32), the eye response component (34) and the host controller/processor (4).
~LZ67976 - ga -The host controller/processor ~4) provides the automation capability of the system. It is possible, within the ambit of this invention, to sequence a number of tests into test batteries to optimize time and space efficiency in the provision of clini-cal service and to increase the power of diagnostic procedures.
Through careful design of a number of test ~ ~ !
12~7~76 batteries, such that each one is specific to certain disease categories or diagnosis requirements, it will be possible to decrease total "worst case" patient testing to khat of a single testing session of less than two hours. ~ence, optimization of the test could be achieved.
Furthermore, a database management facility may be used to permit comparison of individual test results with normative data from the database, thereby to enhance the value of the test apparatus and method of the present invention.
Referring now in more detail to the system block diagram of Figures 2 and 3, upon starting up, the initializa-tion module (38) of the processor (4) initializes the system and passes control to log-on procedure module (40), which provides log-on request at the display (8) of the operator control station (6) in order to allow an operator to start the test session. Once the operator has completed the log-on procedure, the log-on procedure module (40) requests the operator to select system functions, e.g.
development function (46), operator training function (44) or test function (42).
The development function (46) allows modifications and/or enhancements to be added to the system, such that each system could be customized and optimized according to the requirement.
IE the development function (46) is selected, the log-on procedure module (40) passes control to the development function (46) which, in turn, passes control to the system development a~
module (4~). The system is then set for modifications and/or enhancement purposes. ~t the end of such system development, the system development module (~8) passes control to the end routine (68) which, in turn, returns the system back to the initialized stage.
The operator training function (44) provides training sessions for system operation. Such function is provided by the training module ~50). Upon termination of the training session, the training module (50) returns control to the end routine (68) which sets the system back to the initialized stage.
Referring now -to Figure 4, the test function (42) allows tests to be performed. Once the test function (42) is selected ;~ by the operator from the operator control station (6) by using the key~oard (10), the system passes control to the test manual module ~52) which displays further test selection and patient requests on the display (8) at the operator control station (6).
Having completed patient information from the keyboard (10), the ,. , operator can now select either an individual test function (56) or a battery test function (58).
In either case, the system will present further test parameter requests to the operator at the display (8) of the operator control station (6). Thèrefore, the operator can optimize the administration of the test facility by requesting certain parameters or by using default values, without compromising the tests. Furthermore, the system provides .
~Z~9~
interru~t capability to the operator so that tests can be quickly and easily aborted and restarted with the capability to continue from the stopping point of the test.
If the operator selects the individual test function (56), the system passes control to the single test administration module (64) such that the system raquests the operator to select the type of individual test available in the system. Each of these tests provides certain specifications of test parameters in a test file (70) located in storage (54). Each test has a ;10 "query" point where the operator can invoke the default test parameters contai~ed in the test file t70). Also, each test is associated with a stimulus graphics file (72), also located in storage (54). In addition, parameters for patient performance ~` optimization can be provided in test file (70) in order to provide feedback to the patient regarding test performance.
urthermore, each test is associated with an additional file, namely, a patient instruction file (74) which provides information on the display ~14) at the patient station (12) for the patient to carry out the test.
Once the operator has selected the type of test and has '~ provided patient data to the patient data file (62) (if he has selected the single test administration module (64)), or has passed through the test search module (60), (if he has selected the battery test (58)), the system passes control to the test administration module and file generator (66) whereby, based on ~26797~
the information in the test file (70), the stimulus module (76) sets up the proper test sequence by passing control to the appropriate routine. In the case of a visual test, the stimulus module (76) passes control to the visual test module (78) whlch will cause test patterns to be displayed at the display (14) of the patient station (12) and to provide instructions to the patient at the display (14) of the patient station (12). It may also provide audio instructions for visual tests and/or visual instructions for auditory tests. In the case of an auditory function test, the stimulus module (76) passes control to the auditory test module (80), whereby the auditory test module (80) causes test signals to be generated at headphones/speakers (36) of the patient station (12). In addition, the stimulus module (76) communicates with the response requisition module (84) to monitor the response from the patient.
The response requisition module (84) interfaces ~ith the response monitoring subcomponent (28) (see Figure 1) which includes hand response component (30), voice response component (3~) and eye response component (34). The responses are fed into the processor (4) and the data are analyzed by the data analysis module (86). In this way, test results and reports with appropriate graphics can be provided at the end of the test from the hardcopy printer (20) or can be displayed at the display (8) of the station (6) (see Figure 1). Furthermore, results communicated to the patient could also ~e used to provide ~2~i7976 performance feedback to the patient under test in order to optimize patient performance.
Finally, on the completion of the testing session, a message appears on the patient display (14) indicating that the session is complete. The patient data file is updated with the results of the analysis by the test database update module (88). A
~ printout of an interim report of the results of the test may ~e generated by the hardcopy generator module (90) and the system passes control back to the test administration module (68). The operator display (8) is set back to the test selection session.
As noted before, instead of selecting individual tests, the operator can select a test battery. In such a case, control is ~ passed to the test function battery module (58~ such that the ; operator can select a number of tests into the test batteries in order to optimi2e the use of time and space. Then the system passes control to the test search module (60) to set up the test files and parameters. The test search module (60) eventually passes control to the test administration module and file generator (56) and the test session a follows similar path to the 20 single test session from then on.
The image/audio data of the test patterns of all the test sessions are stored in the image storage module (26) which may be ;~ a video disk. It is understood that such device may be substituted by other devices without affecting the performance of the system.
.
1267g7~
Hence it can be seen that the present invention is capable of performing all the procedures common to at least one of visual and auditory tests, as the system provides the facility to set up the operator and patient instructions by the user.
Thus, it is apparent that, in accordance with broad concepts of this invention, a computerized test apparatus has been provided that fully satisfies the objects, aims and advantages set forth above. It will also be apparent to one skilled in the art that thè system may be modified to adapt to the operation of ; a different host controller/processor (4), e.g., a minicomputer or mainframm rompu~mr, or by using diffmrmnt mtoragm ~ans.
; ' ' .
Claims (13)
PROPERTY OR PRIVILEGE IS CLAIMED ARE DEFINED AS FOLLOWS:
1. An interactive diagnostic system of the stimulus-responsive type for evaluating performance levels of a selected at least one of visual, auditory, cognitive, and attentional capacities of a subject, comprising:
(a) a host controller/processor;
(b) generator and displaying means for presenting predetermined sequential input stimuli including at least one of visual stimuli and auditory stimuli to said subject, said stimuli being provided by at least one selected stimuli-generating module in said host controller/processor;
(c) subject response means for registering responses of said subject to said sequential input stimuli and for relaying said responses to said host controller/-processor;
(d) data entry means for instructing said host control-ler/processor to provide said stimuli from said selected stimuli-generating module in a predetermined sequence;
and (e) analysis, storage and communication means interfaced with said host controller/processor to carry out the analysis of test data, the archival storage of recently acquired test data, the comparison with previously stored data and the reporting of test results.
(a) a host controller/processor;
(b) generator and displaying means for presenting predetermined sequential input stimuli including at least one of visual stimuli and auditory stimuli to said subject, said stimuli being provided by at least one selected stimuli-generating module in said host controller/processor;
(c) subject response means for registering responses of said subject to said sequential input stimuli and for relaying said responses to said host controller/-processor;
(d) data entry means for instructing said host control-ler/processor to provide said stimuli from said selected stimuli-generating module in a predetermined sequence;
and (e) analysis, storage and communication means interfaced with said host controller/processor to carry out the analysis of test data, the archival storage of recently acquired test data, the comparison with previously stored data and the reporting of test results.
2. An automated, multi-purpose, real-time apparatus for administration of stimuli to a patient, for evaluating performance levels of a selected at least one of visual, auditory, cognitive and attentional capacities of a patient, using a host/controller processor including memory and mass storage capabilities for storing data and instructions, said apparatus comprising:
(a) an operator station means having an input display means permitting an operator of said apparatus to select individual test parameters, individual tests or sequences of tests;
(b) a patient station means having a display means, an input means for applying stimuli from a selected test to said patient, and a response means for the collec-tion of patient responses to said applied stimuli and for inputting said responses to said host control-ler/processor;
(c) a stimulus generator module at said operator station for providing said stimuli from a selected test and also for providing a real-time image generation means;
and (d) a test measurement module, resident in said host controller/processor, for providing a data capture means for capturing patient responses, for providing an update means for recording patient responses, and for providing a report means for providing test reports and patient optimization feedback signals to said patient station means.
(a) an operator station means having an input display means permitting an operator of said apparatus to select individual test parameters, individual tests or sequences of tests;
(b) a patient station means having a display means, an input means for applying stimuli from a selected test to said patient, and a response means for the collec-tion of patient responses to said applied stimuli and for inputting said responses to said host control-ler/processor;
(c) a stimulus generator module at said operator station for providing said stimuli from a selected test and also for providing a real-time image generation means;
and (d) a test measurement module, resident in said host controller/processor, for providing a data capture means for capturing patient responses, for providing an update means for recording patient responses, and for providing a report means for providing test reports and patient optimization feedback signals to said patient station means.
3. The apparatus of claim 2 including analysis means, said analysis means including a data comparison means and a data storage means.
4. The apparatus of claim 2 wherein said operator station means includes operator control means, said operator control means including means to start, means to stop, and means to restart the test sequence for test optimization.
5. An apparatus according to claim 2, wherein said real-time image generation means includes an interface means for interfacing an image storage means to said host controller/
processor.
processor.
6. An apparatus according to claim 2, wherein said image storage means is a video disk storage device.
7. An apparatus according to claim 2, wherein said host controller/processor includes interfacing means for inputting electrode sensor input signals to said processor.
8. The apparatus of claim 2 wherein said test measurement module also includes an eye movement monitor means for recording eye position and movements.
9. An apparatus according to claim 7, wherein said host controller/processor interface means includes an input means and a display means to enable said operator to provide parameter selection information to said processor.
10. An apparatus according to claim 2, wherein said means for applying stimuli from a selected list includes both a visual stimulation test means, and an auditory stimulation test means.
11. An apparatus according to claim 10, wherein said visual stimulation test means includes a high intensity electric light source and a graphics display means for providing visual and colour stimuli testing signals at said patient station means.
12. An apparatus according to claim 10, wherein said auditory stimulation test means includes an interface means for interfacing an auditory means with the said host controller/processor for providing auditory stimuli testing signals.
13. An apparatus according to claim 8, wherein said eye movement monitor means comprises an infrared light source and an infrared sensitive closed circuit television camera and automated eye movement data analysis means.
Priority Applications (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CA000521869A CA1267976A (en) | 1986-10-30 | 1986-10-30 | Assess system |
Applications Claiming Priority (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CA000521869A CA1267976A (en) | 1986-10-30 | 1986-10-30 | Assess system |
Publications (1)
| Publication Number | Publication Date |
|---|---|
| CA1267976A true CA1267976A (en) | 1990-04-17 |
Family
ID=4134260
Family Applications (1)
| Application Number | Title | Priority Date | Filing Date |
|---|---|---|---|
| CA000521869A Expired - Lifetime CA1267976A (en) | 1986-10-30 | 1986-10-30 | Assess system |
Country Status (1)
| Country | Link |
|---|---|
| CA (1) | CA1267976A (en) |
Cited By (3)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| US5255211A (en) * | 1990-02-22 | 1993-10-19 | Redmond Productions, Inc. | Methods and apparatus for generating and processing synthetic and absolute real time environments |
| ITRM20090347A1 (en) * | 2009-07-03 | 2011-01-04 | Univ Siena | ANALYSIS DEVICE FOR THE CENTRAL NERVOUS SYSTEM THROUGH THE APPLICATION OF DIFFERENT NATURAL STIMULATES COMBINED BETWEEN THEM AND THE STUDY OF THE CORRESPONDING REACTIONS. |
| CN103519832A (en) * | 2013-10-21 | 2014-01-22 | 浙江工业大学 | Memory ability testing device |
-
1986
- 1986-10-30 CA CA000521869A patent/CA1267976A/en not_active Expired - Lifetime
Cited By (4)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| US5255211A (en) * | 1990-02-22 | 1993-10-19 | Redmond Productions, Inc. | Methods and apparatus for generating and processing synthetic and absolute real time environments |
| ITRM20090347A1 (en) * | 2009-07-03 | 2011-01-04 | Univ Siena | ANALYSIS DEVICE FOR THE CENTRAL NERVOUS SYSTEM THROUGH THE APPLICATION OF DIFFERENT NATURAL STIMULATES COMBINED BETWEEN THEM AND THE STUDY OF THE CORRESPONDING REACTIONS. |
| WO2011001457A3 (en) * | 2009-07-03 | 2011-03-17 | Universita' Degli Studi Di Siena | Device for the analysis of the central nervous system by application of a combination of stimuli and the study of corresponding reactions |
| CN103519832A (en) * | 2013-10-21 | 2014-01-22 | 浙江工业大学 | Memory ability testing device |
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