Objective measures for detecting the auditory brainstem response: comparisons of specificity, sensitivity and detection time

Objective: To evaluate and compare the specificity, sensitivity and detection time of various time-domain and multi-band frequency domain methods when detecting the auditory brainstem response (ABR). Design: Simulations and subject recorded data were used to assess and compare the performance of the Hotelling's T-2 test (applied in either time or frequency domain), two versions of the modified q-sample uniform scores test and both the Fsp and Fmp, which were evaluated using both conventional F-distributions with assumed degrees of freedom and a bootstrap approach. Study sample: Data consisted of click-evoked ABRs and recordings of EEG background activity from 12 to 17 normal hearing adults, respectively. Results: An overall advantage in sensitivity and detection time was demonstrated for the Hotelling's T-2 test. The false-positive rates (FPRs) of the Fsp and Fmp were also closer to the nominal alpha-level when evaluating statistical significance using the bootstrap approach, as opposed to using conventional F-distributions. The FPRs of the remaining methods were slightly higher than expected. Conclusions: In this work, Hotelling's T-2 outperformed the alternative methods for automatically detecting ABRs. Its promise as a sensitive and efficient detection method should now be tested in a larger clinical study.