title: Distortion product otoacoustic emissions: hit and false-positive rates in normal-hearing and hearing-impaired subjects.
abstract: OBJECTIVE
  This study aimed to establish hit and false-positive rates for distortion product otoacoustic emissions (DPOAEs) using a commercial instrument.
  
  
  METHODS
  This was a prospective study. The examiners performing the DPOAEs were blinded to pure-tone audiometric results. A decision matrix analysis was used to determine hit and false-positive rates for absolute amplitude, three amplitude-to-noise ratios, and three conditions that combined these two parameters.
  
  
  METHODS
  The study was performed at a tertiary care, outpatient clinical laboratory facility.
  
  
  METHODS
  Subjects with normal hearing and those with sensorineural hearing loss participated in the study.
  
  
  METHODS
  Main outcome measures were hit and false-positive rates for various DPOAE measures.
  
  
  RESULTS
  Hit and false-positive rates were better for high than low frequencies. As absolute amplitude and amplitude-to-noise ratios increased hit and false-positive rates improved. Optimal hit rates generally exceeded 80%; false-positive rates were approximately 20% in the high-frequency range. Although the absolute amplitude measures seemed more useful than various ratio measures, there were advantages to using both parameters clinically.
  
  
  CONCLUSIONS
  DPOAEs have acceptable hit and false-positive rates for high frequencies but not for lower frequencies. DPOAE amplitude-to-noise ratios of +3 and even +6 dB may not be clinically feasible based on the current data. The overall findings obtained on the commercial instrument in this study compare favorably with previous studies of a similar nature.
authors.affiliation: Department of Surgery, Dartmouth-Hitchcock Medical Center, Lebanon, NH 03756-0001, USA.
authors.forename: F E
authors.initials: FE
authors.lastname: Musiek
authors.forename: J A
authors.initials: JA
authors.lastname: Baran
mesh_terms: D000158:Acoustic Impedance Tests; D000161:Acoustic Stimulation; D000328:Adult; D001299:Audiometry; D001309:Auditory Threshold; D003051:Cochlea / Q000503:physiopathology*; D016057:Evoked Potentials, Auditory, Brain Stem; D005260:Female; D006309:Hearing / Q000502:physiology*; D006319:Hearing Loss, Sensorineural / Q000175:diagnosis* / Q000503:physiopathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009622:Noise; D011446:Prospective Studies