Test-retest reliability of distortion-product thresholds compared to behavioral auditory thresholds

•DPOAE level maps allow estimation of hearing thresholds (EHTs) linked to OHC function.•DPOAE level maps are reconstructed with DPOAE amplitudes recorded in L1,L2 space.•Short-pulse DPOAE and an optimum stimulus paradigm allow reliable EHTs.•DPOAE level maps were more reliable than behavioral thresholds at high frequencies 11–14 kHz.•DPOAE level maps are a promising means for serial monitoring of cochlear dysfunction. When referred to baseline measures, serial monitoring of pure-tone behavioral thresholds and distortion-product otoacoustic emissions (DPOAEs) can be used to detect the progression of cochlear damage. Semi-logarithmic DPOAE input-output (I/O) functions enable the computation of estimated distortion-product thresholds (EDPTs) by means of linear regression, a metric that provides a quantitative estimate of hearing loss due to cochlear-amplifier degradation. DPOAE wave interference and a suboptimal choice of stimulus levels limit the accuracy of EDPTs. This work identifies the test-retest reliability of EDPTs derived from short-pulse DPOAE level maps (EDPTLM), a method that circumvents limitations associated with both wave interference and suboptimal choice of stimulus levels. The test-retest reliability was compared to that of EDPTs derived from semi-logarithmic I/O functions (EDPTI/O) and that of behavioral thresholds acquired with pure-tone audiometry (PTA) and modified Békésy tracking audiometry (TA) to provide a foundation for identifying and interpreting significant threshold shifts. The DPOAE-based auditory thresholds (EDPTLM and EDPTI/O) and behavioral thresholds (PTA and TA) were recorded seven times within three months at 14 frequencies with f2 = 1–14 kHz in 20 ears from ten subjects with normal hearing (4PTA0.5–4kHz