Reanalyze Audiogram

This topic explains the basis behind the reanalysis of audiogram tests.

The changes for the single ear baseline move (available in SYSTOC 7.22 and later) are based on a letter of interpretation confirmed by Mr. Richard E. Fairfax, the director of enforcement programs for OSHA, in his interpretation letter of September 9, 2005. On the subject of how far back the employer must correct to be in compliance, Mr. Fairfax stated that “OSHA will usually look at whether the employer is currently out of compliance and, therefore, the employer would not need to go back further than the previous audiogram and ensure all future audiograms are revised in the same manner.”

You may wish to consult with major client companies to determine their preference to have recent dual-ear Standard Threshold Shifts reevaluated for compliance with the single-ear interpretation. If that is their desire, you may use the Reanalyze button for any employee who had a threshold shift on his last examination. If the shift actually applied to only one ear, SYSTOC will correct the baseline move. If your audiologist concurs with SYSTOC’s assessment, provide the employer with a revised report for that employee.

Note: Our Research Department recommends against recalculating historical (pre-2003) data, because a major change in OSHA standards occurred in 2003. Any reanalysis should be on post-2003 data only.

Occasionally, your clinic physician or audiologist may disagree with the way a record has been analyzed, or you may need to modify incorrect test data or designate a record invalid, affecting the interpretation of subsequent results. If the Reanalyze button does not provide satisfactory results, it will be necessary to make the changes manually. Any efforts to modify a patient’s audiogram record should be methodical. It is possible to create a patient record with no reference baseline or create multiple baseline references for a single patient. In many scenarios, SYSTOC will warn you of such incongruities so that you may resolve them. However, it is still the responsibility of the user to verify that any changes made to audiogram records yield appropriate results. Be sure to document the reasons for any change in the F3 memo. Information from the F3 memo can be printed on the Audiogram Analysis Report and the Audiogram Test Report to explain why a record was altered. It is highly recommended that you generate a printout of the Audiogram Test Report, including memo contents and invalid records, before you edit an audiogram record, and again following any changes, to verify that the desired results have been achieved.

If you make changes to any audiogram analysis fields, SYSTOC will display a warning to indicate that editing an analysis field prevents SYSTOC from auto-reanalyzing the record when it is saved, and you are provided an opportunity to stop. If you proceed, you should update any other records that are affected by the change in the edited record. For example, if you decide that a record marked as an STS Reference Baseline is in error, you must also decide which record should become the new STS Reference Baseline and make the appropriate change to that record. In addition, if audiogram tests have been performed subsequent to the first edited record, and you change the baseline against which SYSTOC originally analyzed these results, you must verify that the audio analysis results for these records are valid and revise any that are no longer correct.

The data for an audiogram may be revised by entering new values directly into the editable fields in the Right/Left data portion of the Audiogram screen. When the record is saved, new results will be automatically calculated. It is more likely, however, that a revision to the analysis state of a record will be required. A manual revision to the analysis of an audiogram record is achieved by modifying selections in the Reanalyze portion of the screen.

Note: In either scenario, only the currently selected record is modified and no other audiogram records are automatically recalculated.

Each prior or subsequent record must be reviewed, and if necessary, revised (using Save and/or Reanalyze) to update any invalid analysis results that may be triggered by the change.

Three calculated properties of an audiogram can be manually altered to change the analysis of the record: whether the audiogram is an STS baseline; whether the test result is OSHA reportable; and whether the data are considered invalid. Modifications are made by simply selecting a different option or checking/unchecking a field. If the record has been previously altered, you must press Reanalyze to undo the prior change and return the record to its initial analysis state before you are permitted to make a subsequent modification.

There are three options to describe the STS baseline status of an audiogram record. Use Not STS Baseline Reference Exam to de-select the present audiogram as a baseline to permit selection of a prior exam as the STS baseline against which future records will be analyzed. Use Initial STS Baseline Reference Exam to make the current record a new initial baseline. This option should be used for an employee who leaves, and then returns to, a company. Old audiogram records should not bridge a gap in employment, and a new initial STS baseline exam should be established upon an employee’s return to work. Use STS Baseline Reference Exam to set the displayed exam as the STS baseline.

If you check the OSHA Reportable box, SYSTOC automatically marks the selected record with Threshold Shift and makes it the STS baseline. This is done automatically because a threshold shift is one of the criteria that define an OSHA-reportable event. If you uncheck the OSHA Reportable box, the audiogram will retain the threshold shift and baseline exam status, and SYSTOC will note that the OSHA-reportable status was altered.

If you check the Data invalid or not to be used box, the record will be excluded from future analyses. To reinstate a record that is marked invalid, uncheck the box or press Reanalyze.

Note: Proceed with caution! SYSTOC does not automatically recalculate or reanalyze existing audiogram records for a patient once manual changes are made to an audiogram.