It is anticipated that there could be significant reductions in test time for the same signal to noise ratio by using NB CE-Chirps when testing newborns. This effect may vary in practice and is likely to be most beneficial for babies with low amplitude ABR responses. We propose that the ABR nHL threshold to eHL correction for NB CE-Chirps should be approximately 5 dB less than the corrections for tone pips at 4 and 1 kHz.
The advantages of NB CE-Chirps over tone pips we previously identified at 4 and 1 kHz extends to 0.5 and 2 kHz, which supports the use of NB CE-Chirps when testing newborns. We propose that ABR nHL threshold to eHL corrections for NB CE-Chirps should be approximately 5 dB less than corrections for tone pips at 0.5 and 2 kHz, mirroring our recommendation at 4 and 1 kHz.
The 0.5 kHz data from this study and previous studies were compared. Previous studies suggested lower figures for the bone-conduction stimulus level correction. Likely sources of this discrepancy are discussed. The average 0.5 kHz bone-conduction correction value for infants < 3 months old is about 28 dB. The correction for 1 kHz is 20 dB. We recommend that calibration reference levels used in this study be adopted and that appropriate corrections be applied to bone conduction ABR thresholds in infants < 3 months old before calculation of any air-bone gap and subsequent clinical interpretation.
Objective:
The performance of a modified calculation of F statistic using multiple points (Fmp) in auditory brainstem response (ABR) tests in infants was evaluated.
Design:
Using UK national guidelines, the ABR threshold was established on 50 infant ears at 4 kHz and 41 infant ears at 1 kHz. A specificity-based Fmp criterion for response presence was established from the distribution of no-response values. This criterion was then applied to determine the sensitivity of Fmp in detecting responses.
Results:
A 97.5% true negative rate in no-response waveforms corresponded to an Fmp of 2.2. This criterion detected 85% of 4 kHz and 68% of 1 kHz responses at 10 dB above the ABR threshold but only 51% of 4 kHz and 32% of 1 kHz responses at the ABR threshold.
Conclusions:
Fmp has reasonable clinical utility at stimulus levels above the ABR threshold but is not an adequate replacement for strictly applied conventional waveform interpretation at the ABR threshold. A proposal is offered that should improve Fmp sensitivity.
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