Influence of artifacts and pass/refer criteria on otoacoustic emission hearing screening

A screening device for otoacoustic emission (OAE) testing was evaluated via measurements of click evoked OAEs (CEOAEs) and/or distortion product OAEs (DPOAEs) obtained in normally hearing young adults and newborns. Moreover, measurements were performed in a passive cavity and in ears with severe sensorineural hearing loss, in which the occurrence of a pass result was assumed to indicate artifacts. Different parameter settings were investigated. In comparison to normally hearing young adults, overall pass rates in newborns were similar using CEOAEs (93 to 100%), but lower using DPOAEs (65 to 95% vs. 83 to 100%). Pass rates in ears with severe hearing loss were 10% at 2 kHz, 13% at 3 kHz, and lower at other frequencies. Pass rates in the test cavity were generally low. The influence of test frequency on pass rates and calculations using computer simulation indicated the presence of artifacts. The discrimination of such artifacts from biological signals is difficult or impossible, and they may represent a serious problem for efficient OAE screening.