Norrix Linda W, Velenovsky David
Department of Speech, Language, & Hearing Sciences, The University of Arizona, Tucson.
Am J Audiol. 2018 Mar 8;27(1):25-36. doi: 10.1044/2017_AJA-17-0074.
The auditory brainstem response (ABR) is a powerful tool for making clinical decisions about the presence, degree, and type of hearing loss in individuals in whom behavioral hearing thresholds cannot be obtained or are not reliable. Although the test is objective, interpretation of the results is subjective.
This review provides information about evidence-based criteria, suggested by the 2013 Newborn Hearing Screening Program guidelines, and the use of cross-check methods for making valid interpretations about hearing status from ABR recordings.
The use of an appropriate display scale setting, templates of expected response properties, and objective criteria to estimate the residual noise, signal level, and signal-to-noise ratio will provide quality data for determining ABR thresholds. Cross-checks (e.g., immittance measures, otoacoustic emissions testing, functional indications of a child's hearing) are also needed to accurately interpret the ABR.
Using evidence-based ABR signal detection criteria and considering the results within the context of other physiologic tests and assessments of hearing function will improve the clinician's accuracy for detecting hearing loss and, when present, the degree of hearing loss. Diagnostic accuracy will ensure that appropriate remediation is initiated and that children or infants with normal hearing are not subjected to unnecessary intervention.
听觉脑干反应（ABR）是一种强大的工具，可用于对无法获得行为听力阈值或行为听力阈值不可靠的个体的听力损失的存在、程度和类型做出临床决策。尽管该测试是客观的，但结果的解释却是主观的。
本综述提供了2013年新生儿听力筛查计划指南所建议的基于证据的标准，以及使用交叉核对方法从ABR记录中对听力状况做出有效解释的相关信息。
使用适当的显示比例设置、预期反应特性的模板以及估计残余噪声、信号水平和信噪比的客观标准，将为确定ABR阈值提供高质量数据。还需要进行交叉核对（例如，声导抗测量、耳声发射测试、儿童听力的功能指标）以准确解释ABR。
使用基于证据的ABR信号检测标准，并结合其他生理测试和听力功能评估来考虑结果，将提高临床医生检测听力损失的准确性，以及在存在听力损失时确定听力损失程度的准确性。诊断准确性将确保启动适当的治疗措施，并确保听力正常的儿童或婴儿不会受到不必要的干预。
