The aim of this study was to provide a statistical evaluation of the screening properties of distortion product otoacoustic emissions (DPOEs) in individuals with clinically normal hearing and in patients with pure sensorineural deafness of various degrees. The main informational parameters used were sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and the analysis of receiver operating characteristic (ROC) curves. For each frequency tested, ears were classified as a function of their audiometric threshold. Two groups were defined relative to an arbitrary reference, the “audiometric criterion.” The PPV decreased and NPV increased with increases in the audiometric criterion. Each point of the ROC curve represents the relationship between the false alarm rate and the hit rate for each audiometric criterion ranging between 10 and 75 dB hearing level: the lower the audiometric criterion, the lower the hit rate value, and the lower the false alarm value. The audiometric criterion giving the highest hit rate and the lowest false alarm rate was 55 to 60 dB hearing level for primaries at 60 and 70 dB sound pressure level, or 25 to 30 dB hearing level for primaries at 30,40, and 50 dB sound pressure level. These two different behaviors of ROC curves are consistent with the hypothesis that DPOEs do not represent activity at a single location along the basilar membrane.
GaskillSABrownAM. The behavior of the acoustic distortion product, 2f1-f2, from the human ear and its relation to auditory sensitivity. J Acoust Soc Am1990; 89: 821–39.
2.
Lonsbury-MartinBLHarrisFPStagnerBBHawkinsMDMartinGK. Distortion product emissions in humans. I. Basic properties in normally hearing subjects. Ann Otol Rhinol Laryngol1990; 99(Suppl 147): 3–14.
3.
ProbstRLonsbury-MartinBLMartinGK. A review of otoacoustic emissions. J Acoust Soc Am1991; 89: 2027–67.
4.
KimDOMolnarCEMatthewsJW. Cochlear mechanics: nonlinear behavior in two-tone responses as reflected in cochlear-nerve-fiber responses and in ear-canal sound pressure. J Acoust Soc Am1980; 67: 1704–21.
5.
MenshBDPattersonMCWhiteheadMLLonsbury-MartinBLMartinGK. Distortion-product emissions in rabbit. I. Altered susceptibility to repeated pure-tone exposures. Hear Res1993; 70: 50–64.
6.
SuttonLALonsbury-MartinBLMartinGKWhiteheadML. Sensitivity of distortion-product otoacoustic emissions in humans to tonal over-exposure: time course of recovery and effects of lowering L2. Hear Res1994; 75: 161–74.
7.
BrownAMMcDowellAForgeA. Acoustic distortion products can be used to monitor the effects of chronic gentamicin treatment. Hear Res1989; 42: 143–56.
8.
BrownAM. Acoustic distortion from rodent ears: a comparison of responses from rats, guinea pigs and gerbils. Hear Res1987; 31: 25–38.
9.
JohnstoneBMGleichBMavadatNMcAlpineDKapadiaS. Some properties of the cubic distortion tone emissions in the guinea pig. Adv Audiol1990; 7: 57–62.
10.
NortonSJRubelEW. Active and passive ADP components in mammalian and avian ears. In: DallosPGeislerCDMathewsJWRuggeroMASteeleCR, eds. The mechanics and biophysics of hearing. New York, NY: Springer-Verlag, 1990: 219–27.
11.
PopelkaGROsterhammelPANielsenLHRassmussenAN. Growth of distortion-product otoacoustic emissions with primary-tone level in humans. Hear Res1993; 71: 12–22.
12.
MillsDMNortonSJRubelEW. Development of active and passive mechanics in the mammalian cochlea. Aud Neurosci1994; 1: 77–99.
13.
BonfilsPAvanPElbezMDeysSErminyMFrancoisM. Auditory threshold evaluation by distortion-product otoacoustic emissions using decision support system. Acta Otolaryngol (Stockh) 1994; 114: 360–5.
PrieveBAGorgaMPSchmidtAR. Analysis of transient-evoked otoacoustic emissions in normal-hearing and hearing-impaired ears. J Acoust Soc Am1993; 93: 3308–19.
20.
HeNJSchmiedtRA. Fine structure of the 2f1-f2 acoustic distortion product: changes with primary level. J Acoust Soc Am1993; 94: 2659–69.
21.
SunXMSchmiedtRAHeNJLamCF. Modeling the fine structure of the 2f1-f2 acoustic distortion product. II. Model evaluation. J Acoust Soc Am1994; 96: 2175–83.
22.
HallJWHornsbyBKellyT. Similarities and differences in distortion product otoacoustic emissions (DPOAE) among five commercially-available devices [Abstract]. Abstr Assoc Res Otolaryngol1996; 709: 178.
23.
AllenJBFaheyPF. Using acoustic distortion products to measure the cochlear amplifier gain on the basilar membrane. J Acoust Soc Am1992; 92: 178–88.
24.
BonfilsPAvanPFrancoisMTrotouxJNarcyP. Otoacoustic emissions in audiology. A perspective. Ear Hear1990; 11: 155–8.
25.
BonfilsPAvanP. Distortion-product otoacoustic emissions. Values for clinical use. Arch Otolaryngol Head Neck Surg1992; 118: 1069–76.
26.
MartinGKOhlmsLAFranklinDJHarrisFPLonsbury-MartinBL. Distortion product emissions in humans. III. Influence of sensorineural hearing loss. Ann Otol Rhinol Laryngol1990; 99(Suppl 147): 30–42.
27.
WhiteheadMLLonsbury-MartinBLMartinGK. Evidence for two discrete sources of 2f1-f2 distortion-product otoacoustic emission in rabbit: I. Differential dependence on stimulus parameters. J Acoust Soc Am1992; 91: 1587–607.
28.
MillsDMRubelEW. Variation of distortion product otoacoustic emissions with furosemide injection. Hear Res1994; 77: 183–99.
29.
MartinBL LonsburyMartinGKProbstRCoatsAC. Acoustic distortion products in rabbit ear canal. I. Basic features and physiological vulnerability. Hear Res1987; 28: 173–89.
30.
NortonSJBargonesJYRubelEW. Development of otoacoustic emissions in gerbil. Evidence for micromechanical changes underlying development of the place code. Hear Res1991; 51: 73–92.
31.
FaheyPFAllenJB. Nonlinear phenomenon as observed in the ear canal and at the auditory nerve. J Acoust Soc Am1985; 77: 599–612.
32.
HamernikRPPattersonJHTurrentineGAAhroonWA. The quantitative relation between sensory cell loss and hearing thresholds. Hear Res1989; 38: 199–212.
33.
DallosPHarrisD. Properties of auditory nerve responses in absence of outer hair cells. J Neurophysiol1978; 41: 365–83.
34.
KiangNYSLibermanMCLevineRA. Auditory-nerve activity in cats exposed to ototoxic drugs and high-intensity sounds. Ann Otol Rhinol Laryngol1976; 85: 752–68.
35.
LibermanMCDoddsLW. Single-neuron labelling and chronic cochlear pathology. III. Stereocilia damage and alterations in threshold tuning curves. Hear Res1984; 16: 55–74.
