Open Source Mobile Software Platform for Distributed Studies of Hearing

March 3, 2016

Marc Shapiro, Creare, LLC
Hector Galloza, 2GaRi
Odile Clavier, PhD, Creare, LLC
Douglas Brungart, PhD, Walter Reed Military Medical Center

Overview

Overview

System:
  • Tablet based platform for administering customized hearing assessments and questionnaires

Architecture:
  • Platform written as web application, allowing it to be deployed to multiple tablet operating systems from one code base
  • Publicly available Open-Source

Deployment:
  • Deployed to over 100 tablets at multiple sites, collecting over 6000 individual test records
  • Testing by Walter Reed National Military Medical Center and Creare

Future:
  • Server Agnostic Design
  • Creare Headset connected to TabSINT

Awknowledgement

This code development was supported by the US Army Medical Research Materiel Command and the Army Public Health Command under SBIR Phase III Award #W81XWH-13-C-0194 to Creare LLC.

In particular, we gratefully acknowledge the support and contributions of the Audiology and Speech Center at the Walter Reed National Military Medical Center and the Department of Defense Hearing Center of Excellence in the development and extensive testing of this software.

Team

PI:

Odile Clavier

Team:

Marc Shapiro, Rob Chambers, Jesse Norris, Jed Wilbur, Brendan Flynn, Bill Finger, Rich Kaszeta, Marc Ramsey, Connor Murphy

PI:

Douglas Brungart

Team:

Hector Galloza, Amanda Holmes, Tom Heil, Matt Makashay, General Lee, Ben Sheffield, Ben Sactler (Sensimetrics)

System Overview

TabSINT

Objective

Design Protocol

  • Develop customized study protocol
    • Utilize text-based templates to create questionnaires and speech-in-noise assessments
    • Include images, audio, and video files
  • Design protocol logic
    • Adaptive on-the-fly changes to output levels
    • Change protocol content depending on user response

Design Protocol

  • Protocol currently developed using a text-based (json) format
  • Future: Excel and web-based protocol development

Response Areas

Questionnaire

Speech In Noise

Creare Headset

  • Multiple Choice
  • Yes/No Input
  • Button Grid
  • Likert
  • See-Saw
  • Checkbox
  • Textbox
  • Image Map
  • Integer Input
  • Multiple Input
  • MRT
  • OMT
  • CRM
  • Three Digit Task
  • QuickSIN
  • Bekesy-Like
  • Bekesy-Frequency
  • Three Digit
  • Hughson-Westlake
  • Hughson-Westlake Frequency
  • Tone Generation
  • DPOAE
  • Audiometry Results Plot

Deploy Protocol to Tablets

  • Protocols uploaded to the cloud server
  • Media files are calibrated for specific headset
  • Protocol assigned to site on server

Deploy Protocol to Tablets

  • Tablets subscribed to site automatically download, update, and render protocol
  • Different sites can host different protocols

Administer

  • Study participants step through protocol
  • Detailed logging keeps a record of the participants path through the protocol
  • When the participant finishes, results and logs are automatically uploaded to central server

Analyze

  • Results are stored in a robust, scalable database on the cloud server
  • Results can be queried and download in a variety of data formats (json, excel, csv) for analysis

Demonstration

A Live Demo is available on the TabSINT Website:

http://creare-com.github.io/tabsint/demo

Software Architecture

Software Architecture

benefits:
  • single code base
  • deployable across platforms
  • primarily uses the ubiquitous languages of the web

TabSINT Plugins

  • TabSINT includes plugin Application Programming Interface (API)
    • Allows external features to interface with TabSINT
  • 3 Plugins currently implemented:
    • Creare Headset (Creare)
    • Sound Level Meter (Sensimetrics + WRNMMC)
    • Bluetooth Connection (Sensimetrics + WRNMMC)

Open Source Development

The source code for TabSINT has been released publicly on GitHub

Theory: Integrating the users of software into the development process leads to better software

Open Source Process

Deployment

Overall Statistics

Since 2014, The TabSINT system has processed:

108 Unique Tablets
74 Unique Sites
166 Unique Protocols
6185 test results uploaded

This includes debugging, testing, and deployment

Creare Activity

3 separate locations, multiple studies
  • Only shipped hardware (Tablets + Creare Headset)
  • Tablet downloaded site-specific protocol
  • Singapore
    • 120 participants in 1 week
    • Remotely debugged and updated protocol
  • University of Northern Colorado
    • Comfort Fit (Questionnaire): 40 participants
    • New Belgium Hearing Study: 20 participants
    • Test ReTest Study: 40 participants
  • House Clinic
    • RetSPL Study: 30 participants
    • Noise Tolerance: in progress

WRNMMC Deployment

Currently 6 active protocols, over 4000 subjects collected since 8/2014

  • FIT: 9 Sites, about 1000 subjects collected since 08/2014
  • CAPD: 3 Sites more than 500 subjects collected since 11/2014
  • Prevalence:3 sites, more than 2000 subjects collected since 6/2015
  • 3D: DiLorenzo TRICARE Health Clinic, over 700 subjects collected since 06/2015
  • HCE Climate Survey: Developed in collaboration with HCE, about 30 surveys collected at JDVAC

WRNMMC TabSINT Development

WRNMMC TabSINT Development

  • Researcher describes protocol, provides media and literature to developer

  • Back and Forth between researcher and developer until protocol meets researcher needs
    • Pros: Highly flexible; almost any type of protocol can be implemented
    • Cons: Time consuming; researcher relies heavily on developer

  • Currently Beta testing a development mode to empower researchers
    • Pros: No programming experience, can develop protocol in minutes
    • Cons: Not very flexible

WRNMMC Excel to TabSINT

WRNMMC Excel to TabSINT

WRNMMC TabSINT Development

Future Development

Server Agnostic Design

Goal: Allow TabSINT to run without centralized server

Potential Implementation:

  • Deploy protocols using:
    • Git-capable repository (i.e. GitHub, Gitlab)
    • Dropbox or other file-syncing
  • Specify content of results output in protocol
  • Save results to external storage (i.e. SD card, Dropbox)

Creare Headset

  • Highly attenuating headset
  • Audiometer in the ear cups
  • Connects to TabSINT via Bluetooth using the Creare Headset TabSINT Plugin
  • Automated, mobile, audiometric quality hearing tests

Review

  • Open TabSINT enables researchers to administer customized hearing-related tests and questionnaires across multiple sites
    • 25+ response areas designed for administering hearing-related assessments
    • TabSINT Plugin API makes the program flexible and extendable

  • Used by WRNMMC and Creare in multiple studies across multiple locations

  • Open source deployment makes the software available to researchers across the world to use and adapt to their specific needs

We hope to continue improving the software with contributions from the hearing assessment community

Questions

Application Website: http://creare-com.github.io/tabsint
  • Includes live demo, documentation, and this presentation

Source: https://github.com/creare-com/tabsint

Creare: http://www.creare.com/

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