HARK data resource
The Harmonized Auditory Research Knowledgebase is a working proposal for a FHIR-aligned model of hearing-health data, grounded in audiology's native standards (LOINC, SNOMED CT, ICD-10-CM). What you see on this page is the consortium's v0.1 design artifact: the entities, mappings, and a synthetic sample record. Real audiometric data have not yet been ingested or harmonized into HARK; pilots are planned for Y1 and a consortium-validated v0.5 is targeted for Y2.
State of the resource
The schema, ontology mappings, and sample bundle on this page are proposed deliverables of the consortium's planned harmonization work. They are not yet a queryable database, and the build-out is contingent on project funding. Site-level pilot extracts are planned for Year 1.
Counts referenced elsewhere (more than 1,000,000 audiograms from over 600,000 patients) describe the aggregate scope of source records identified across the five contributing sites, not harmonized rows currently loaded into HARK.
- Audiograms (source-level scope)
- 1M+
- Patients (source-level scope)
- 600K+
- Contributing sites
- 5
across contributing sites
across contributing sites
academic medical centers
01 · Schema
Subject → Encounter → Measurement, mapped to clinical standards
An audiology-native, encounter-anchored relational model. Every measurement (audiogram, tympanometry, OAE, ABR, speech, SIN) belongs to an Encounter; encounters belong to Subjects. Diagnoses, devices, and exposures attach at the Subject level. Switch tabs for the diagram, the entity browser, or the ontology crosswalk.
02 · Sample record
A synthetic patient in three views
The same synthetic audiogram, rendered as a FHIR R4 Bundle, as a flat table, and as a clinical-convention audiogram chart. Illustrative only; no identifiable or production patient data are shown.
{
"resourceType": "Bundle",
"id": "hark-sample-bundle-001",
"type": "collection",
"meta": {
"tag": [
{
"system": "https://hearshare.org/fhir/CodeSystem/data-tag",
"code": "synthetic",
"display": "Synthetic, illustrative only; do not use for clinical decisions"
},
{
"system": "https://hearshare.org/fhir/CodeSystem/hark-version",
"code": "0.1.0",
"display": "HARK v0.1 (proposed)"
}
]
},
"entry": [
{
"fullUrl": "urn:uuid:patient-001",
"resource": {
"resourceType": "Patient",
"id": "patient-001",
"meta": {
"tag": [
{
"system": "https://hearshare.org/fhir/CodeSystem/data-tag",
"code": "synthetic"
}
]
},
"identifier": [
{
"system": "https://hearshare.org/id/subject",
"value": "HARK-SUBJ-000001"
}
],
"gender": "female",
"extension": [
{
"url": "https://hearshare.org/fhir/StructureDefinition/birth-year-decade",
"valueString": "1960s"
}
]
}
},
{
"fullUrl": "urn:uuid:encounter-001",
"resource": {
"resourceType": "Encounter",
"id": "encounter-001",
"status": "finished",
"class": {
"system": "http://terminology.hl7.org/CodeSystem/v3-ActCode",
"code": "AMB",
"display": "ambulatory"
},
"type": [
{
"coding": [
{
"system": "http://snomed.info/sct",
"code": "33879002",
"display": "Audiometry"
}
]
}
],
"subject": {
"reference": "urn:uuid:patient-001"
},
"period": {
"start": "2031-04-12",
"end": "2031-04-12"
}
}
},
{
"fullUrl": "urn:uuid:obs-audiogram-right-001",
"resource": {
"resourceType": "Observation",
"id": "obs-audiogram-right-001",
"status": "final",
"category": [
{
"coding": [
{
"system": "http://terminology.hl7.org/CodeSystem/observation-category",
"code": "exam"
}
]
}
],
"code": {
"coding": [
{
"system": "http://loinc.org",
"code": "28615-3",
"display": "Audiometry study"
},
{
"system": "http://snomed.info/sct",
"code": "252884004",
"display": "Pure tone audiometry"
}
],
"text": "Pure-tone air-conduction thresholds, right ear"
},
"subject": {
"reference": "urn:uuid:patient-001"
},
"encounter": {
"reference": "urn:uuid:encounter-001"
},
"effectiveDateTime": "2031-04-12",
"bodySite": {
"coding": [
{
"system": "http://snomed.info/sct",
"code": "25577004",
"display": "Right ear"
}
]
},
"method": {
"coding": [
{
"system": "http://snomed.info/sct",
"code": "252884004",
"display": "Pure tone audiometry, air conduction"
}
]
},
"extension": [
{
"url": "https://hearshare.org/fhir/StructureDefinition/hark-masking",
"valueBoolean": true
},
{
"url": "https://hearshare.org/fhir/StructureDefinition/hark-transducer",
"valueString": "insert"
}
],
"component": [
{
"code": {
"coding": [
{
"system": "http://loinc.org",
"code": "39124-3",
"display": "AC threshold 250 Hz, right"
}
]
},
"valueQuantity": {
"value": 15,
"unit": "dB[HL]",
"system": "http://unitsofmeasure.org",
"code": "dB[HL]"
}
},
{
"code": {
"coding": [
{
"system": "http://loinc.org",
"code": "39137-5",
"display": "AC threshold 500 Hz, right"
}
]
},
"valueQuantity": {
"value": 20,
"unit": "dB[HL]",
"system": "http://unitsofmeasure.org",
"code": "dB[HL]"
}
},
{
"code": {
"coding": [
{
"system": "http://loinc.org",
"code": "39126-8",
"display": "AC threshold 1000 Hz, right"
}
]
},
"valueQuantity": {
"value": 25,
"unit": "dB[HL]",
"system": "http://unitsofmeasure.org",
"code": "dB[HL]"
}
},
{
"code": {
"coding": [
{
"system": "http://loinc.org",
"code": "39140-9",
"display": "AC threshold 2000 Hz, right"
}
]
},
"valueQuantity": {
"value": 35,
"unit": "dB[HL]",
"system": "http://unitsofmeasure.org",
"code": "dB[HL]"
}
},
{
"code": {
"text": "AC threshold 3000 Hz, right (HARK extension)"
},
"valueQuantity": {
"value": 45,
"unit": "dB[HL]",
"system": "http://unitsofmeasure.org",
"code": "dB[HL]"
}
},
{
"code": {
"coding": [
{
"system": "http://loinc.org",
"code": "39144-1",
"display": "AC threshold 4000 Hz, right"
}
]
},
"valueQuantity": {
"value": 55,
"unit": "dB[HL]",
"system": "http://unitsofmeasure.org",
"code": "dB[HL]"
}
},
{
"code": {
"text": "AC threshold 6000 Hz, right (HARK extension)"
},
"valueQuantity": {
"value": 60,
"unit": "dB[HL]",
"system": "http://unitsofmeasure.org",
"code": "dB[HL]"
}
},
{
"code": {
"text": "AC threshold 8000 Hz, right (HARK extension)"
},
"valueQuantity": {
"value": 65,
"unit": "dB[HL]",
"system": "http://unitsofmeasure.org",
"code": "dB[HL]"
}
}
]
}
},
{
"fullUrl": "urn:uuid:obs-audiogram-left-001",
"resource": {
"resourceType": "Observation",
"id": "obs-audiogram-left-001",
"status": "final",
"category": [
{
"coding": [
{
"system": "http://terminology.hl7.org/CodeSystem/observation-category",
"code": "exam"
}
]
}
],
"code": {
"coding": [
{
"system": "http://loinc.org",
"code": "28615-3",
"display": "Audiometry study"
},
{
"system": "http://snomed.info/sct",
"code": "252884004",
"display": "Pure tone audiometry"
}
],
"text": "Pure-tone air-conduction thresholds, left ear"
},
"subject": {
"reference": "urn:uuid:patient-001"
},
"encounter": {
"reference": "urn:uuid:encounter-001"
},
"effectiveDateTime": "2031-04-12",
"bodySite": {
"coding": [
{
"system": "http://snomed.info/sct",
"code": "25577005",
"display": "Left ear"
}
]
},
"extension": [
{
"url": "https://hearshare.org/fhir/StructureDefinition/hark-masking",
"valueBoolean": true
},
{
"url": "https://hearshare.org/fhir/StructureDefinition/hark-transducer",
"valueString": "insert"
}
],
"component": [
{
"code": {
"text": "AC threshold 250 Hz, left"
},
"valueQuantity": {
"value": 20,
"unit": "dB[HL]",
"system": "http://unitsofmeasure.org",
"code": "dB[HL]"
}
},
{
"code": {
"coding": [
{
"system": "http://loinc.org",
"code": "39138-3",
"display": "AC threshold 500 Hz, left"
}
]
},
"valueQuantity": {
"value": 25,
"unit": "dB[HL]",
"system": "http://unitsofmeasure.org",
"code": "dB[HL]"
}
},
{
"code": {
"coding": [
{
"system": "http://loinc.org",
"code": "39127-6",
"display": "AC threshold 1000 Hz, left"
}
]
},
"valueQuantity": {
"value": 30,
"unit": "dB[HL]",
"system": "http://unitsofmeasure.org",
"code": "dB[HL]"
}
},
{
"code": {
"coding": [
{
"system": "http://loinc.org",
"code": "39141-7",
"display": "AC threshold 2000 Hz, left"
}
]
},
"valueQuantity": {
"value": 40,
"unit": "dB[HL]",
"system": "http://unitsofmeasure.org",
"code": "dB[HL]"
}
},
{
"code": {
"text": "AC threshold 3000 Hz, left (HARK extension)"
},
"valueQuantity": {
"value": 50,
"unit": "dB[HL]",
"system": "http://unitsofmeasure.org",
"code": "dB[HL]"
}
},
{
"code": {
"coding": [
{
"system": "http://loinc.org",
"code": "39145-8",
"display": "AC threshold 4000 Hz, left"
}
]
},
"valueQuantity": {
"value": 60,
"unit": "dB[HL]",
"system": "http://unitsofmeasure.org",
"code": "dB[HL]"
}
},
{
"code": {
"text": "AC threshold 6000 Hz, left (HARK extension)"
},
"valueQuantity": {
"value": 65,
"unit": "dB[HL]",
"system": "http://unitsofmeasure.org",
"code": "dB[HL]"
}
},
{
"code": {
"text": "AC threshold 8000 Hz, left (HARK extension)"
},
"valueQuantity": {
"value": 70,
"unit": "dB[HL]",
"system": "http://unitsofmeasure.org",
"code": "dB[HL]"
}
}
]
}
},
{
"fullUrl": "urn:uuid:obs-wrs-right-001",
"resource": {
"resourceType": "Observation",
"id": "obs-wrs-right-001",
"status": "final",
"code": {
"coding": [
{
"system": "http://loinc.org",
"code": "57028-2",
"display": "Word recognition score"
}
]
},
"subject": {
"reference": "urn:uuid:patient-001"
},
"encounter": {
"reference": "urn:uuid:encounter-001"
},
"effectiveDateTime": "2031-04-12",
"bodySite": {
"coding": [
{
"system": "http://snomed.info/sct",
"code": "25577004",
"display": "Right ear"
}
]
},
"valueQuantity": {
"value": 88,
"unit": "%",
"system": "http://unitsofmeasure.org",
"code": "%"
},
"extension": [
{
"url": "https://hearshare.org/fhir/StructureDefinition/hark-word-list",
"valueString": "NU-6"
}
]
}
},
{
"fullUrl": "urn:uuid:diag-report-001",
"resource": {
"resourceType": "DiagnosticReport",
"id": "diag-report-001",
"status": "final",
"code": {
"coding": [
{
"system": "http://snomed.info/sct",
"code": "33879002",
"display": "Audiometry"
}
]
},
"subject": {
"reference": "urn:uuid:patient-001"
},
"encounter": {
"reference": "urn:uuid:encounter-001"
},
"effectiveDateTime": "2031-04-12",
"result": [
{
"reference": "urn:uuid:obs-audiogram-right-001"
},
{
"reference": "urn:uuid:obs-audiogram-left-001"
},
{
"reference": "urn:uuid:obs-wrs-right-001"
}
],
"conclusion": "Mild-to-moderate sloping sensorineural hearing loss, bilateral, symmetric. WRS reduced commensurate with PTA."
}
},
{
"fullUrl": "urn:uuid:condition-snhl-001",
"resource": {
"resourceType": "Condition",
"id": "condition-snhl-001",
"clinicalStatus": {
"coding": [
{
"system": "http://terminology.hl7.org/CodeSystem/condition-clinical",
"code": "active"
}
]
},
"code": {
"coding": [
{
"system": "http://hl7.org/fhir/sid/icd-10-cm",
"code": "H90.3",
"display": "Sensorineural hearing loss, bilateral"
},
{
"system": "http://snomed.info/sct",
"code": "60700002",
"display": "Sensorineural hearing loss"
}
]
},
"bodySite": [
{
"coding": [
{
"system": "http://snomed.info/sct",
"code": "63622000",
"display": "Both ears"
}
]
}
],
"subject": {
"reference": "urn:uuid:patient-001"
},
"encounter": {
"reference": "urn:uuid:encounter-001"
}
}
},
{
"fullUrl": "urn:uuid:device-ha-001",
"resource": {
"resourceType": "DeviceUseStatement",
"id": "device-ha-001",
"status": "active",
"subject": {
"reference": "urn:uuid:patient-001"
},
"timingDateTime": "2031-05-03",
"device": {
"display": "Bilateral receiver-in-canal hearing aids (synthetic)"
},
"bodySite": {
"coding": [
{
"system": "http://snomed.info/sct",
"code": "63622000",
"display": "Both ears"
}
]
}
}
}
]
}03 · Provenance & quality
Provenance as a first-class entity
HARK's schema models provenance, de-identification policy, and data quality alongside the measurements themselves. The page documents that design; rows themselves do not yet exist.
Sites
Source-site identification
Each row is intended to carry a source-site code for the five contributing institutions (MEE, Duke, MUSC, UMD, OHSU) so that site-level effects can be examined in any analysis.
Dates
Date-shift policy
A per-subject random date offset is planned. Within-subject intervals are preserved; absolute calendar dates are not retained in the analytic release.
PHI
De-identification
Structured fields are removed under HIPAA Safe Harbor. Free-text fields are scrubbed using NLP-based PHI removal pipelines provided by BDSP. Ages above 89 are capped per Safe Harbor.
DQ
Quality framework
Conformance, completeness, and plausibility checks are planned, drawing on widely used data-quality dimensions for clinical research data.
04 · Use it
Roadmap, downloads, and how to get involved
The schema artifacts below describe the model, not the contents of any database. Access procedures are being finalized; reach out while they are.
v0.1 schema (today)→v0.5 (site pilots harmonized, Y2)→v1.0 (consortium release, Y3)
Full roadmapAccess
Access procedures are TBD. Investigators and institutions interested in using or contributing to HARK are welcome to reach out while they're finalized.