Automated electrophysiologic hearing testing using a threshold-seeking algorithm.

The efficacy of utilizing an automated algorithm to identify auditory brainstem responses (ABR) was studied. A microcomputer-based threshold-seeking algorithm utilizing click-evoked ABR was developed to determine evoked-response thresholds for automated hearing screening. The software consists of an evoked-response recognizer unit, which determines the presence or absence of a response, and a threshold-tracking unit, which controls the click intensity in order to track the threshold. The response recognizer is based upon correlation methods. Threshold tracking is accomplished using a Parameter Estimation by Sequential Testing (PEST) procedure, which is commonly used to study psychophysical properties of the auditory system. Sound level is automatically adjusted, based on the results of the recognizer and the threshold tracker. Test results were generally obtained in less than 15 minutes per ear. The results of the automated procedure correlate very highly with expert judgments of ABR threshold and show good test-retest reliability, suggesting that automated procedures are viable alternatives to traditional testing methods.