Evoked otoacoustic emissions and auditory brainstem responses: concordance in hearing screening among high-risk children

OBJECTIVE: Evoked otoacoustic emissions (OAEs) and diagnostic auditory brainstem responses (ABRs) were determined in 379 high-risk children referred for hearing screening. MATERIAL AND METHODS: This was a retrospective, cross-sectional study. The records of 379 children referred for hearing screening between January 2002 and March 2003 at the Ear Unit of the Philippine General Hospital were evaluated. RESULTS: Of the 379 children, 53.6% were male and 46.4% were female and the mean age was 41+/-47 months. The age distribution was as follows: < or = 12 months, 32.2%; 12-24 months, 52.2%; and > 24 months, 11%. Out of 229 right and 232 left ears, 111 (48.5%) and 112 (48.3%) had "pass" responses and 113 (49.3%) and 116 (50.5%) had "refer" responses, respectively. Five right and four left ears had "noise" responses. Out of 266 right and 209 left ears, the ABR results showed 72 (27.1%) and 30 (14.4%) with normal auditory pathways and 194 (72.9%) and 179 (85.6%) with abnormal auditory pathways, respectively. Of the 131 children whose parents gave their consent for concomitant OAE and ABR testing, agreements were observed between the two tests in terms of classifying the results as normal or abnormal of 78.9% (kappa = 0.51; p = 0.00) in right and 78.6% (kappa = 0.51; p = 0.00) in left ears. When the children were classified as either "with hearing loss-bilateral abnormal ABRs" or "at least one normal ABR", there was an observed agreement of 81% (kappa = 0.6; p = 0.00). OAEs had a sensitivity of 76.9% (95% CI 66.7-84.8%) and a specificity of 90% (95% CI 75.4-96.7%). CONCLUSION: There is good concordance between OAE and ABR results among high-risk children referred for hearing screening.