Detecting high-frequency hearing loss with click-evoked otoacoustic emissions

Douglas H. Keefe, Shawn S. Goodman, John C. Ellison, Denis F. Fitzpatrick, Michael P. Gorga

Research output: Contribution to journalArticlepeer-review

27 Scopus citations


In contrast to clinical click-evoked otoacoustic emission (CEOAE) tests that are inaccurate above 4-5 kHz, a research procedure measured CEOAEs up to 16 kHz in 446 ears and predicted the presence/absence of a sensorineural hearing loss. The behavioral threshold test that served as a reference to evaluate CEOAE test accuracy used a yes-no task in a maximum-likelihood adaptive procedure. This test was highly efficient between 0.5 and 12.7 kHz: Thresholds measured in 2 min per frequency had a median standard deviation (SD) of 1.2-1.5 dB across subjects. CEOAE test performance was assessed by the area under the receiver operating characteristic curve (AUC). The mean AUC from 1 to 10 kHz was 0.90 (SD = 0.016). AUC decreased to 0.86 at 12.7 kHz and to 0.7 at 0.5 and 16 kHz, possibly due in part to insufficient stimulus levels. Between 1 and 12.7 kHz, the medians of the magnitude difference in CEOAEs and in behavioral thresholds were 4 dB. The improved CEOAE test performance above 4-5 kHz was due to retaining the portion of the CEOAE response with latencies as short as 0.3 ms. Results have potential clinical significance in predicting hearing status from at least 1 to 10 kHz using a single CEOAE response.

Original languageEnglish (US)
Pages (from-to)245-261
Number of pages17
JournalJournal of the Acoustical Society of America
Issue number1
StatePublished - Jan 2011

ASJC Scopus subject areas

  • Arts and Humanities (miscellaneous)
  • Acoustics and Ultrasonics


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