Otoacoustic emission tests in neonatal screening programmes.

Otoacoustic emission (OAE) testing has many characteristics which suit it for use as an objective neonatal auditory screener. The most important of these is the speed with which it can be performed. This feature alone opens up the possibility of much more general neonatal screening programmes. We here review the important considerations in applying otoacoustic testing to neonatal screening applications, and discuss the future role of OAE testing. Practical considerations in applying the technique are illustrated by examples and experiences drawn from a pilot whole-population neonatal screening project. Unselected screening takes us into unexplored territory. Test failure rate will inevitably far exceed the real incidence of hearing impairment. The concept of rapid whole-population neonatal OAE screening techniques as an additional risk factor detector rather than a definitive hearing test seems more appropriate to the low incidence of hearing impairment in the population and to the ethical problems surrounding early and erroneous diagnosis of hearing impairment.