Biomedical subjects

C L Flick

Publications and source records attributed to C L Flick.

6 recordsLinked to original sources

PubMed2000

Computer-automated clinical technique for tinnitus quantification.

This study addresses the need for uniformity in techniques for clinical quantification of tinnitus. Because automation can be an effective means to achieve standardization, this laboratory is developing techniques to perform computer-automated tinnitus testing. The present study was conducted to demonstrate the feasibility of obtaining reliable tinnitus measures using a fully automated system. A computer-controlled psychoacoustical system was developed to quantify tinnitus loudness and pitch using a tone-matching technique. Hearing thresholds were also obtained as part of the procedure. The system generated test stimuli and simultaneously controlled a notebook computer positioned in the sound chamber facing the patient. The notebook computer displayed instructions for responding and relayed response choices through on-screen "buttons" that the patient touched with a pen device. Twenty individuals with tinnitus were evaluated with the technique over two sessions, and responses were analyzed for test-retest reliability. Analyses revealed good reliability of thresholds, loudness matches, and pitch matches. These results demonstrate that use of a fully automated system to obtain reliable measurements of tinnitus loudness and pitch is feasible for clinical application.

Adult↗

PubMed1999

Stroke rehabilitation. 4. Stroke outcome and psychosocial consequences.

This self-directed learning module highlights recent research in assessment of stroke outcomes and management of the psychosocial consequences of stroke. It is a part of the chapter on stroke rehabilitation in the Self-Directed Physiatric Education Program for practitioners and trainees in physical medicine and rehabilitation. This article discusses predictive factors for mortality and functional recovery; proposed case mix adjustment and prospective payment systems for stroke rehabilitation; continuum of care and utilization of acute, nursing home, outpatient and home health rehabilitation programs; reintegration and socialization after stroke; vocational rehabilitation of stroke patients; and management of the psychosocial effects of stroke on patients and families.

Aged↗

PubMed1999

Reliability of tinnitus loudness matches under procedural variation.

Repeated tinnitus loudness matches (LMs) were obtained to determine response reliability using a computer-automated technique with two procedural variations, fixed or random step sizes, to increase output level during the initial ascending series of tones at each frequency. Twenty subjects with stable, tonal tinnitus were evaluated with both methods during each of two sessions. Response instructions were displayed on a portable computer, and a pen device was used to make response choices that appeared on the touch-sensitive video monitor. For each method, hearing thresholds and LMs were obtained, with 1-dB resolution, at 1/3-octave frequencies from 1 to 16 kHz. Analyses revealed reliability of LMs to be equivalent between methods. LM data are reported in both dB SPL and dB SL, with the SPL values providing greater reliability both within and between sessions (all r's > or = .889, p's < or = .0001).

Acoustic Impedance Tests↗

PubMed1990

Intraoperative perfusion contrast echocardiography. Initial experience during coronary artery bypass grafting.

Intraoperative evaluation of the effectiveness of myocardial revascularization has been limited by an inability to assess regional myocardial perfusion. Microbubbles of sonicated diatrizoate sodium and diatrizoate meglumine (Renografin) have been an effective echocardiographic contrast agent and have been employed clinically during cardiac catheterization. This recent development in contrast-enhanced two-dimensional echocardiography permits real-time imaging of transmural myocardial blood flow but has not been evaluated in the operating room. This study represents the initial surgical application of this directed technique and was designed to evaluate the safety and efficacy of intraoperative perfusion contrast echocardiography in assessing the results of coronary artery bypass grafting. Twenty men with significant coronary artery disease ranging in age from 49 to 73 years were studied. Direct contrast agent injection into completed saphenous vein bypass grafts caused the myocardium supplied by each graft to be well delineated and provided a tomographic view of contrast distribution. The enhanced region was well correlated with the size and distribution of the native vessel. Rapid contrast washout (less than 20 seconds) indicated satisfactory regional perfusion. Contrast echocardiography prolonged the operation less than 10 minutes and did not result in any perioperative complications.

Aged↗

PubMedDate not supplied

Comparison of two computer-automated procedures for tinnitus pitch matching.

Clinical assessment of the perceptual characteristics of tinnitus usually includes an attempt to match the pitch of tinnitus to a pure tone. A standardized clinical protocol for tinnitus pitch matching does not yet exist, and there is a history of unsuccessful attempts to obtain such measures reliably. The present study was designed to evaluate new protocols for identifying the perceived pitch of tinnitus, with the objectives of reducing testing time and improving test-retest reliability. Two protocols ("Octave" and "Binary") were developed, each of which was patterned after the testing procedure previously developed at the Oregon Tinnitus Clinic and used to assess thousands of tinnitus patients. Both protocols use computer-automation to conduct testing; the protocols differ according to their specific testing algorithms. Twenty subjects with nonfluctuating tinnitus were each tested over two sessions. Results of testing revealed that both protocols could obtain pitch matches within 20 to 25 min. Reliability of responses was good for some subjects but not others, and the Binary protocol generally provided more reliable results.

Adult↗

PubMedDate not supplied

Reliability of hearing thresholds: computer-automated testing with ER-4B Canal Phone earphones.

This study was conducted to document test-retest reliability of hearing thresholds using our computer-automated tinnitus matching technique and Etymotic ER-4B Canal Phone insert earphones. The research design involved repeated threshold measurements both within and between sessions, and testing to evaluate the potential effect of eartip removal and reinsertion. Twenty normal-hearing subjects were evaluated over two testing sessions with the use of a fully automated protocol for determining thresholds with 1-dB precision. Thresholds were first obtained at 0.5-16.0 kHz, in one-third octave frequency steps (16 test frequencies). The octave frequencies were then retested, first without removing the eartips, then after eartip removal and replacement. Responses between sessions differed by an average of 2.5 dB across all 16 test frequencies, and 91.5 percent of the repeated thresholds varied within +/-5 dB (98.1 percent within +/-10 dB). Reliability of within-sessions thresholds was also good, and there was no effect of eartip removal and replacement.

Adult↗