Objective: Despite great progress towards optimizing DPOAE primary tone characteristics, factors such as stimulus and intra-subject emission variability have not been addressed. The purpose of this study was to identify optimal primary tone level relationships when these sources of variability were acknowledged, and to identify any influences of test frequency.
Design: Following coupler-based measurements assessing primary tone level stability, two experiments were conducted. In experiment 1, DPOAE test-retest reliability without probe replacement was measured for f2 = 1-6 kHz with L1 = L2 = 65 dB SPL. In experiment 2, optimal L1-L2 relationships were identified for f2 = 1-6 kHz. For 20 ≤ L2 ≤ 75 dB SPL, L1 was varied 15 dB SPL above and below the recommendation of L1 = 0.4 L2 + 39 [dB SPL].
Study sample: Eleven normal-hearing adults participated in experiment 1. Thirty normal-hearing adults participated in experiment 2.
Results: Stimulus variability did not exceed 0.1 dB SPL. DPOAE reliability testing revealed an across-frequency mean standard error of measurement of 0.52 dB SPL. The average optimal L1-L2 relationship was described by L1 = 0.49 L2 + 41 [dB SPL]. A significant effect of frequency was identified for 6 kHz.
Conclusion: Including relevant sources of variability improves internal validity of a primary tone level optimization formula.
Keywords: Otoacoustic emissions; anatomy and physiology; instrumentation; medical audiology; pediatrics.