Cochlear Mechanisms and Otoacoustic Emission Test Performance.

The study included people aged 12 to 80 years, not newborns or young children, so it may not apply to the population usually screened with OAEs. Only ears with normal middle-ear function and thresholds below 60 dB HL at 1 to 4 kHz were included, so it says nothing about more severe losses or middle-ear problems. The sample was deliberately enriched with ears likely to produce errors, so overall accuracy was lower than in a general screening population. The smoothing technique required lengthy testing and is not suitable for routine clinical use. SFOAEs cannot currently be recorded with clinical instruments, and the amplitude-modulated technique used here has not been thoroughly tested. The subset analysis with confirmed fine structure excluded many normal ears, especially uncertain ones, so its findings may not reflect routine patients. In-the-ear canal calibration was used, which may have contributed to some errors, particularly at 4 kHz. Some accuracy values in the uncertain group at 4 kHz fell below chance because the recruitment strategy included normal ears with small emissions and impaired ears with large emissions.

The supplied text does not include a funding or conflict-of-interest declaration. The publication types list Research Support, N.I.H., Extramural.

Do not conclude that smoothing DPOAE fine structure should replace clinical DPOAE screening. In the full group it did not improve accuracy over the best standard condition, and the benefit appeared only in a selected subset with confirmed fine structure.