Improving Distortion-Product Otoacoustic Emission Test-Retest Reliability With Forward-Pressure Level Calibration on Clinical Equipment

FPL calibration provided clinically meaningful improvements in test-retest reliability with SPL, especially above 4 kHz. With the longer averaging in E2, improvements in reliability were seen down to 1 kHz. Smaller changes in DPOAEs in individual ears can be reliably detected, potentially allowing for earlier intervention with serial monitoring. Clinically significant shift criteria, however, should be established by replicating actual testing conditions using a control group from the population of interest, with the same DPOAE protocol used with patients and a more representative time (on the order of days or months) between the test and retest.