Acoustic distortion products otoacustic emissions (DPOAE) in neonatal screening

The purpose of the work was to determine the feasibility of direct nursery DPOAE testing in a universal hearing screening, evaluate the results and calculate the reliability of this test vs. Auditory Brainstem Responses (ABR). To this purpose DPOAE (sweep and I/O test) were performed on 500 children born between January and August 1996 at the Civil Hospital of Mestre, Italy. All the children were examined in the nursery, no matter what the risk factors or specific motivations. Besides determining whether the examination could be performed, its specificity and sensitivity, the time required and any variation depending on the day of testing were also evaluated. In a high percentage of cases (11.2%) it proved impossible to perform the test. In addition, when compared to ABR, the percentage of false positives was rather high (16.2%) and specificity was 84%. As conceived, the test requires 6'09" per ear. Comparison of the differences in results according to day of execution did not appear significant although there was a lower percentage of false positive after the third day of life. DPOAE can be measured in the nursery. The high number of false positives and the frequent need to repeat the measurements, however, increase the amount of time required for this test, thus voiding any time savings over an ABR screening: a test which is rather lengthy by provides a high degree of specificity.