Survey of Auditory Brainstem Response Referral Criteria

The primary objective of the project was to survey recognized “experts” in the field of neurodiagnostic audiology and practicing audiologists regarding their referral criteria and referral patterns for administering an auditory brainstem response test (ABR). For purposes of this study, “expert” was defined as any recognized audiologist with at least two or more publications and/or seminars in the field of auditory evoked potentials. Responses of experts and practicing audiologists were compared and contrasted to establish: a) if there was a standard referral pattern; b) what, if any, were the apparent critical components of referral patterns; and, c) whether or not current practice reflected the utilization of such critical components. The survey was designed to establish whether the respondent was practicing, in what type of practice setting, and how often ABRs were performed. Specificity and sensitivity of ABR outcomes was also requested. The survey was administered verbally, via telephone, to 3 experts and was sent via e-mail to 178 randomly selected audiologists in the United States. Of the latter 53 returned, 38 reported conducting ABRs. Thus, data analysis was reported on 38 respondents. The survey results did not reveal a consistent standard referral pattern. Critical components for referral were hypothesized based on the “expert” majority response. These include ABR referral based on the presence of: (1) asymmetric sensorineural hearing loss; (2) unilateral tinnitus; (3) positive reflex decay; and, (4) word recognition rollover. The majority of “non-expert” practitioners surveyed reported that these symptoms warranted consideration for referral, thus reflecting utilization of apparent critical components