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This quick guide outlines the procedure for creating a pass/refer ABRIS test protocol. Parameters and settings should be based on an appropriate pass/refer criterion.

1. Open the Titan Suite software and click on the ABRIS tab.
2. Go to Menu | Setup | Protocol setup.
   
3. Click on “New” and type the desired protocol name in the “Selected protocol” box.
4. Select the desired stimulus type, stimulus intensity and rejection level from the dropdown menus.
     
5. Set the desired test stop criteria (test time and residual noise limit).
   
6. Select the desired test conditions (electrode montage for us, turn Bayesian weighting on or off and Enable Pass/Refer to display result labels).
   
7. Select the desired display options for the test results and EEG.
   

Note: Screen-shots in this document are a guide only and are not necessarily the recommended settings for an ABRIS pass/refer protocol. Refer to the Titan Additional Information document for a more detailed description of the various criteria.

This quick guide outlines the procedure for creating a pass/refer DPOAE test protocol. Parameters and settings should be based on an appropriate pass/refer criterion.

1. Open the Titan Suite software and click on the DPOAE tab.
2. Go to Menu | Setup | Protocol setup.
3. In the Protocol setup screen, click on New and type in the desired protocol name in the Selected protocol box.
4. From the Available tests box, double click on DP-Gram. DP-Gram (Unconfigured) will now appear in the Selected tests box.
5. Click on the Settings button below the Selected tests box.
6. In the Frequency (f2) box, type in each of the required frequencies for testing. Press Add after each frequency. Alternatively, use the Add series option
   
   
7. The Basic and Advanced tabs offer options to change the L1-L2 levels, set the Acceptable noise level (level above which OAE recording will be rejected due to noise), the f2/f1 ratio and the level tolerance. Choose to measure at ambient or peak pressure.
   
8. Under the Common test settings – Stop criteria tab, select the following:
   1. Test time – select from a maximum test time (test runs in loops until time expires) or maximum point time (seconds tested per frequency test point).
   2. Include DP criteria as stop criteria – this box should remain checked to include the DP criteria as stop criteria.
   3. Enable Pass/refer – check this box and accept the disclaimer.
   4. Minimum number of points required for a pass – select the minimum number of test points required to label the result as a pass.
   5. Include residual noise as stop criterion – check this box to include the residual noise as a stop criterion.
      
9. Under DP criteria, the following can be set:
   1. Minimum DP level – the minimum level in dB SPL that the OAE must be measured at.
   2. SNR – the minimum signal-to-noise ratio that must be reached.
   3. DP tolerance – how stable the OAE must be over time.
   4. Residual noise - defines at which level the residual noise is considered to be so silent that a DPOAE would have been detected, if it were present.
   5. Required for a pass – specific frequencies that must be detected for a pass can be set.
      
10. Under DP reliability – set how reliable the DPOAE measurement must be. It is not recommended to set this below 98% as this will reduce the reliability of the measurement.
    
11. Under Display, the following can be set:
    1. Ears – select whether to show one ear or both ears on screen. The summary view displays the test and point summary in table format.
    2. Details – select bar view (simple view) or graph view (advanced view of signal and noise).

    When graph view is selected, choose to display the probe check and/or the response graph.
    

12. Once all settings have been selected. Press OK to close the Protocol setup window.
13. Press Apply and OK to save the protocol and return to the test screen.

Note: Screen-shots in this document are a guide only and are not recommended settings for a DPOAE pass/refer protocol. Refer to the Titan Additional Information document for a more detailed description of the various criteria.

Introduction
This Quick Guide is intended to provide basic instructions on how to work with protocol setups in the AC440 module in the Affinity^2.0 and Callisto^TM suites.

Working with Individual Setups (Test Protocols)
There are many different demands and wishes regarding how an audiometer should both function and appear depending on the specific situation and national standards. One of the greatest advantages of the AC440 module is the flexibility, enabling you to tailor the system according to your specific preferences in the so-called “test protocols”. Below describes basic functionality on how to work with the AC440 Protocols.

Selecting a Test Protocol:

1. Launch the Affinity 2.0 or Callisto™ Suite from Noah, OtoAccess™, or stand-alone.
2. Ensure you are in the AC440 screen. Click on the AUD tab if Audiometry is not the default startup screen.
3. Under Protocols and Sessions, both factory test protocols with standard/factory test parameters and personalized test protocols can be selected.

NOTE: The protocols available in the drop down will depend on whether factory defaults or country specifics defaults were chosen during the installation of the Affinity 2.0 or Callisto™Suite. Therefore, certain test protocols may be hidden. To hide or un-hide protocols, go to Menu | Setup | Show/Hide Protocols.

The AC440 Main Setup:

Once in the AC440 Setup, available tests will be listed to the left. Each test can be unfolded to access its options. Each test contains the following options:

Startup: These are the settings in which the test will start up.
Common: Allows for setting up more general settings of the specific test.
Keyboard: Allows for setting up macros for the dedicated Affinity 2.0 /Equinox 2.0 audiometry keyboard (if this is used).
Add-ons: Allows for setting up add-on features/subtests if available for a test. These require a special license.

NOTE: Some setup screens contain more than one tab offering multiple user controls.

In each setup screen, the following three buttons are found in the lower right corner:

• Clicking OK will close the AC440 setup and save all changes.
• Clicking Cancel will close the AC440 setup without saving any changes made.
• Clicking Apply will save changes but without closing the AC440 Setup. The change will, however, immediately be active and visible on the screen behind the setup dialog.

Creating new Protocols/Changing a Test Protocol Permanently

1. Click Menu | Setup | AC440 setup to enter the Main setup.
2. Click New to create a new test protocol.
3. A pop up window will appear, asking which settings to copy. Choose the protocol to be copied from the drop down menu and re-name the new protocol. Click Apply.
   
4. The new protocol name will now appear in the list of protocols and it will now be possible to modify the settings. Browse the options and amend as desired.
   
   NOTE: For detailed setup options regarding each individual test available in the AC440, please refer to the Affinity 2.0 and Callisto™ Additional Information documents.
   
   
5. When finished click OK (or Apply) to save the changes.

Changing a Test Protocol Temporarily
To make changes to the setup temporarily:

1. From the drop down menu, ensure that the desired protocol to be changed is the chosen one.
2. Enter the Temporary Setup by clicking the button in the front screen (or alternatively select Menu/Setup/Temporary setup).
3. The Temporary Setup is identical to the Main setup. Browse the setup options to make temporary changes as if creating a test protocol and click OK.
   
   
   After the temporary changes have been applied, there will be an asterisk (*) beside the protocol name.
   

Importing and Exporting Test Protocols
The AC440 also allows you to import and export test protocols to other AC440 users.
Exporting a Test Protocol:

1. Go to the AC440 Setup (Menu | Setup | AC440 setup).
2. Click on Export.
3. Select if the file is to be saved as “read only”. In this case the protocol file is locked and the clinician receiving it will not be able to make changes to it.
   
4. Browse for the location on the PC or USB where the test protocol is to be saved.
   
5. Click Save. Other AC440 users will now be able to upload the test protocol using the Import function.

Importing a Test Protocol:

1. Go to the AC440 Setup (Menu | Setup | AC440 setup).
2. Click Import and browse to the location on the PC or USB where the test protocol file has been saved.
   
3. Click Open.
4. The test protocol will then appear under Name.
5. After saving it by clicking OK the test protocol can be selected in the List of defined protocols in the front screen.

Note: If the protocols were exported as “Read Only”, imported protocols will not be able to be imported edited.

This quick guide outlines the procedure for creating a pass/refer TEOAE test protocol. Parameters and settings should be based on an appropriate pass/refer criterion.

1. From the TEOAE tab, go to Menu | Setup | Protocol setup.
2. In the Protocol setup screen, click on New and type in the desired protocol name.
3. From the Available tests box, double click on TEOAE. TEOAE (Unconfigured) will now appear in the Selected tests box.
4. Click on the Settings button below the Selected tests box.
5. Select the band method from the Method box. Enter the specific frequency bands for custom bands.
   
6. The Basic and Advanced tabs offer options to change the stimulus type (non-linear click is almost always used), stimulus level, high pass filter, level tolerance and set the Acceptable noise level (level above which OAE recording will be rejected due to noise). Choose to measure at ambient or peak pressure.
   
7. Under the Common test settings – Stop criteria tab, select the following:
   1. Test time – select from a maximum test time or maximum number of sweeps.
   2. Include TE criteria as stop criteria – this box should remain checked to include the TE criteria as stop criteria.
   3. Enable Pass/Refer – check this box and accept the disclaimer.
   4. Minimum number of bands required for a pass – select the minimum number of bands required to label the result as a pass. 
      
8. Under TE criteria, the following can be set:
   1. Min SNR – the minimum signal-to-noise ratio that must be reached.
   2. Mandatory – specific frequency bands that must be detected for a pass.
   3. Min sweeps – the minimum number of sweeps that must be recorded.
   4. Min total OAE – the minimum total OAE value (0 to +30).
   5. Min reproducibility – the minimum reproducibility between the A & B waveforms.
   6. Min TE level – the minimum acceptable absolute OAE level in SPL.
      
9. Under Recording Window – set the recording window and the wave reproducibility window. The stimulus rate will be displayed as changes to the recording window are made.
   
10. Under Display, the following can be set:
    1. Ears – select whether to show one ear or both ears on screen. The summary view displays the test and band summary in table format.
    2. View TE – select to display the result in a basic view (OAE detected or not) or advanced view (displays OAE and noise). Select to show SNR numbers.
    3. Additional views – select whether to display the stimuli & probe check or the response waveform on screen.
       
11. Once all settings have been selected. Press OK to close the Protocol setup window.
12. Press Apply and OK to save the protocol and return to the test screen. 

Note: Screen-shots in this document are a guide only and are not recommended settings for a TEOAE pass/refer protocol. Refer to the Titan Additional Information document for a more detailed description of the various criteria.

This quick guide outlines the procedure for creating a pass/refer DPOAE test protocol. Parameters and settings should be based on an appropriate pass/refer criterion.

1. Open the Titan Suite software and click on the DPOAE tab.
2. Go to Menu | Setup | Protocol setup.
3. In the Protocol setup screen, click on New and type in the desired protocol name in the Selected protocol box.
4. From the Available tests box, double click on DP-Gram. DP-Gram (Unconfigured) will now appear in the Selected tests box.
5. Click on the Settings button below the Selected tests box.
6. In the Frequency (f2) box, type in each of the required frequencies for testing. Press Add after each frequency. Alternatively, use the Add series option
7. 
8. The Basic and Advanced tabs offer options to change the L1-L2 levels, set the Acceptable noise level (level above which OAE recording will be rejected due to noise), the f2/f1 ratio and the level tolerance. Choose to measure at ambient or peak pressure.
   
9. Under the Common test settings – Stop criteria tab, select the following:
   1. Test time – select from a maximum test time (test runs in loops until time expires) or maximum point time (seconds tested per frequency test point).
   2. Include DP criteria as stop criteria – this box should remain checked to include the DP criteria as stop criteria.
   3. Enable Pass/refer – check this box and accept the disclaimer.
   4. Minimum number of points required for a pass – select the minimum number of test points required to label the result as a pass.
   5. Include residual noise as stop criterion – check this box to include the residual noise as a stop criterion.
      
10. Under DP criteria, the following can be set:
    1. Minimum DP level – the minimum level in dB SPL that the OAE must be measured at.
    2. SNR – the minimum signal-to-noise ratio that must be reached.
    3. DP tolerance – how stable the OAE must be over time.
    4. Residual noise - defines at which level the residual noise is considered to be so silent that a DPOAE would have been detected, if it were present.
    5. Required for a pass – specific frequencies that must be detected for a pass can be set.
       
11. Under DP reliability – set how reliable the DPOAE measurement must be. It is not recommended to set this below 98% as this will reduce the reliability of the measurement.
    
12. Under Display, the following can be set:
    1. Ears – select whether to show one ear or both ears on screen. The summary view displays the test and point summary in table format.
    2. Details – select to show results in a basic view (OAE detected or not) or a more advanced graphical view of the data (displays OAE and noise).
       
13. Once all settings have been selected. Press OK to close the Protocol setup window.
14. Press Apply and OK to save the protocol and return to the test screen.

Note: Screen-shots in this document are a guide only and are not recommended settings for a DPOAE pass/refer protocol. Refer to the Titan Additional Information document for a more detailed description of the various criteria.

What is the Rate Study Protocol?
The preprogrammed Rate Study test is designed to evaluate the integrity of the auditory nerve and look for retrocochlear lesion abnormalities.. Changes in response latency between fast stimulation rates and slow stimulation rates are recorded and compared. The Eclipse offers both slow and fast markers and performs the calculation between the inter-peak Wave V latencies (between Left and Right) as well as the intra-peak latency shift change from slow to fast rate.

How does it Work?
The test is run like a traditional ABR. The clinician tests at a high intensity (i.e.. 90dBHL) with a slow rate (i.e. 7.7Hz). A second run is completed using a fast rate (i.e. 57.7Hz). The Wave V for all four tracings is marked with the appropriate markers. After they are marked, the interaural wave V and the intra-aural shift from the rate change is calculated.

An interaural wave V latency difference greater than 0.2 to 0.4ms is generally considered abnormal (Bauch et al., 1996; Selters & Branckmann,1977)

References
Bauch, C.D., Olsen, W. O., & Pool, A. F. (1996) ABR indices: Sensitivity, specificity, and tumor size. American Journal of Audiology. (5) 97-104.

Selters, W. A. & Brackmann, D. E. (1977) Acoustic Tumor Detection with brain stem electric response audiometry. Archives of otolaryngology. (103) 181-187.

This Quick Guide is intended to give a brief introduction on how to work with, create or edit protocols in the Affinity 2.0 and Callisto™ software suites.

Introduction
The Affinity 2.0 and Callisto™ software suites all have pre-defined protocols. Most of these protocols can easily be copied, modified or created from new. These modifications can be either permanent or temporary.

Working with Protocols
Selecting a standard test protocol:

1. Open the Affinity 2.0 Suite from your patient management system, Noah, OtoAccess™, or stand-alone.
2. Click on the REM tab
3. In the List of Protocols, all customized and standard test protocols are listed.
   

Designing a New Customised Test Protocol

1. Enter the REM440 setup by pressing Menu/Setup/REM440 setup.
2. Press New. A pop-up will ask whether the new test protocol should be based on a copy of the currently selected test protocol. When asked by the message box:
   YES: The system will create a copy of the current test and allow you to add new tests, make changes, and save it under a new name.
   NO: The Selected tests section will be blank and you can create a new test from scratch.
   
3. Name the test protocol setup in the Selected protocol section.
4. Select the tests to be included in the test protocol. Mark a test by clicking on it and press the Add. Double clicking on a test will also select it. Choose all the tests for the test protocol using this procedure.
5. To remove a test selected by mistake, select it under Selected tests and press Remove. The test will then jump back to the Test selection list.
   
6. If the order of the tests is to be changed, use the two Move arrow buttons.
   Mark the test to be moved and press one of the arrow buttons. Depending on the direction of the selected arrow, the test will then jump up or down.
7. To make adjustments to the parameters of each selected test press Settings. This will open a new window similar to below.
   
   In this window you can manipulate your individual parameters which relate to the test within your test battery including renaming, input level, stimulus type, curve smoothing index etc. Once you have set and are happy with this, please click Apply to save and keep the screen open or OK to save and Exit. Pressing Cancel will exit the window and discard your amendments.
8. You may also notice that in the bottom left corner of the Test settings window that there are additional settings (see below). These settings can help you to define how you want your software to be displayed and how curves are grouped via the Combined Screen section. You can also default your REM protocol to select the most recent Audiogram here. Finally, your prescription settings can be defaulted in this section by clicking on Fitting Prescription.
   
   Note: Prior to creating a new test protocol you may wish to select a protocol type in the Protocols to view dropdown list. This function is practical if you for example wish to create a new protocol based on elements from a pre-existing protocol prior to creation. When asked if the new protocol should be based on a copy of the currently selected protocol, click yes. See step 2. above.

Importing and Exporting Test Protocols
The REM440 also allows you to import and export test protocols to other REM440 users.

Exporting a Test Protocol:

1. Go to the REM440 Setup (Menu | Setup | REM440 setup).
2. Click on Export.
3. Select if the file is to be saved as “read only”. In this case the protocol file is locked and the clinician receiving it will not be able to make changes to it.
   
4. Browse for the location on the PC or USB where the test protocol is to be saved
   
   Click Save. Other REM440 users will now be able to upload the test protocol using the Import function.

Importing a Test Protocol:

1. Go to the REM440 Setup (Menu | Setup | REM440 setup).
2. Click Import and browse to the location on the PC or USB where the test protocol file has been saved.
   
3. Click Open.
4. The test protocol will then appear under Name.
5. After saving it by clicking OK the test protocol can be selected in the List of defined protocols in the front screen.

Note: If the protocols were exported as “Read Only”, imported protocols will not be able to be edited.

This Quick Guide is intended to give a brief introduction on how to work with, create or edit protocols in the Affinity 2.0 and Callisto™ software suites.

Introduction
The Affinity 2.0 and Callisto™ software suites all have pre-defined protocols. Most of these protocols can easily be copied, modified or created from new. These modifications can be either permanent or temporary.

Working with Protocols
Selecting a standard test protocol:

1. Open the Affinity 2.0 Suite from Noah, OtoAccess™, or stand-alone.
2. Click on the HIT tab.
3. In the List of Protocols, all customized and standard test protocols are listed.
   

 Designing a New Customized Test Protocol

1. Enter the HIT440 setup by pressing Menu/Setup/HIT440 setup.
2. Press New. A pop-up will ask whether the new test protocol should be based on a copy of the currently selected test protocol. When asked by the message box:
   YES: The system will create a copy of the current test and allow you to add new tests, make changes, and save it under a new name.
   NO: The Selected tests section will be blank and you can create a new test from scratch.
   
3. Name the test protocol setup in the Selected protocol section.
4. Select the tests to be included in the test protocol. Mark a test by clicking on it and press the Add. Double clicking on a test will also select it. Choose all the tests for the test protocol using this procedure.
5. To remove a test selected by mistake, select it under Selected tests and press Remove. The test will then jump back to the Test selection list.
6. If the order of the tests is to be changed, use the two Move arrow buttons.
   Mark the test to be moved and press one of the arrow buttons. Depending on the direction of the selected arrow, the test will then jump up or down.
7. To make adjustments to the parameters of each selected test press Settings.
   
8. In General settings find the following additional options:
   

   Display combined screen allows for comparing different curves by default in the same graph. The option is also available from the front screen. Which curves to compare can be setup individually (see section Error! Reference source not found.).
   
   Coupler allows you to select the preferred coupler to be used in the test protocol. Select from 0.6 cc, 1.2 cc, 2 cc, and Ear simulator (IEC 711).
   
   Note: Prior to creating a new test protocol you may wish to select a protocol type in the Protocols to view dropdown list. This function is practical if you for example wish to create a new protocol based on elements from the ANSI or IEC standard. In this case the dropdown list can be used to select an ANSI or IEC standard before clicking New. When asked if the new protocol should be based on a copy of the currently selected protocol, click yes.