Otoacoustic emission criteria for neonatal hearing screening

Transient evoked otoacoustic emission measures are gaining acceptance as a technique in new-born hearing screening. At present a wide variety of pass-fail screening criteria are used in otoacoustic emission screening programs. In a study of 100 special care neonates and 35 well, full term babies, a number of screening criteria were examined for sensitivity and specificity characteristics when compared to a standard auditory brainstem response protocol. Results indicate that, for normal and special care neonates with a gestational age at test of 38-41 weeks, high sensitivity ( > 80%) could be obtained when a pass-fail criterion involving analysis of emission reproducibility, or emission reproducibility and emission response level, was set. Sensitivity was reduced for special care neonates who fell outside this age range. Specificity was found to be relatively low overall (always < 65%) and may relate to clinical factors in special care neonates not investigated in this study.