Objective: People who manage newborn hearing screening programs are often told that repeating OAE hearing screening more than two or three times per ear unacceptably increases the probability of false-negatives (i.e., passing babies who have permanent hearing loss). This study evaluated the accuracy of that recommendation.

Design: A 2.0 cc coupler and three human ears with hearing loss were used to estimate the number of false-negative results per 1,000 OAE screening tests. Using those results, together with the prevalence of hearing loss among newborns, we calculated the number of babies that would be missed due to repeated testing.

Results: If 100,000 newborn ears were each tested 10 times, only 1% of the ears with hearing loss would be missed due to statistical probability of false-negatives resulting from repeated testing.

Conclusions: Excessive repeated testing in a newborn hearing screening program waste time, raises questions about the accuracy of the test, and may disturb the infant, family, or hospital staff. However, repeated OAE testing does not cause a significant number of babies with hearing loss to pass the test. Additionally, not repeating screening tests often enough can cause serious problems.