Developing standards for distortion product otoacoustic emission measurements.

Characteristics of distortion product otoacoustic emission (DPOAE) measurements were investigated by comparing responses from two different emission measurement systems in 40 volunteers (78 ears) and making test-retest measurements of each system in 20 ears. For transformation of results between systems, it was shown that the minimum data set consisted of input-output (growth) functions obtained by stepping stimulus levels across a wide range, for each set of stimulus frequencies (1-8 kHz). Linear transformations were considered which involved either recalibration of the emission amplitude (vertical transformation) or of the stimulus levels (horizontal transformation). Horizontal transformations provided better agreement between growth functions from the two systems. For frequencies 4-8 kHz, the means of the horizontal shifts required ranged from 8 to 14 dB, clearly exceeding test-retest variability. The optimal horizontal transformation was derived and applied uniformly to all emission measurements; correlations r=0.81-0.89 were found between transformed emission amplitudes. To minimize the necessity for such transformations and to reduce the variability found both within and between systems, development of standardized equipment and methods is suggested for DPOAE measurements, including: (1) an optimized in-ear probe assembly; (2) use of intensity calibration; and (3) a focus on emission "threshold" measurement and analysis.