Cochlear Reflectance and Otoacoustic Emission Predictions of Hearing Loss.
Stephen T Neely, Sara E Fultz, Judy G Kopun and 2 others
PMID 30399010WHAT IT FOUND
DPOAEs outperformed cochlear reflectance when each used one frequency.
Cochlear reflectance improved with multiple frequencies and separate sex criteria, but took longer. A single DPOAE at 6 kHz was fast and accurate for overall hearing screening.
Key findings
01Single-frequency DPOAEs were more accurate than cochlear reflectance for hearing status, with average test-accuracy scores of 0.852 and 0.758 on a scale where 0.5 is chance and 1.0 is perfect.
02Cochlear reflectance became more accurate with multiple frequencies and separate sex criteria, reaching test-accuracy score 0.944 and average threshold error 15.8 dB.
03A single DPOAE at 6 kHz predicted overall hearing loss with test-accuracy score 0.942; at a 28.8 dB cutoff, 95% of overall normal-hearing participants passed and 18% of overall hearing-impaired participants passed.
STILL TO COME
How it was doneWhat they foundWhat it means for SLPs
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What it does not show
The tested ears were selected to get measurable responses, often favouring better-hearing ears or mild-to-moderate loss, so the results may not apply to all ears. The researchers adjusted the cochlear reflectance analysis settings before the reported analysis to improve test performance, which may make those results optimistic. Many predictor variables were reduced to 15 components because some regression models did not converge, so the final models are simplified. DPOAE measurements did not cover frequencies below 1 kHz, and equipment limits affected thresholds at 16 kHz. The study reports prediction accuracy, not whether using these tests improves real clinical decisions or patient outcomes.
Declared interests
Research support is listed as N.I.H., Extramural. The supplied text does not include an author conflict-of-interest declaration.
The easy way to misread this
Do not conclude that cochlear reflectance is ready to replace DPOAE or audiometry. In this study, single-frequency cochlear reflectance was less accurate than DPOAE, took longer, and the best cochlear reflectance results required multiple frequencies and separate criteria for males and females.