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Stimulus-frequency otoacoustic emissions (SFOAEs) can be useful tools for assessing cochlear function noninvasively. However, there is a lack of reports describing their utility in predicting hearing capabilities. Data for model training were collected from 245 and 839 ears with normal hearing and sensorineural hearing loss, respectively. Based on SFOAEs, this study developed an objective assessment system consisting of three mutually independent modules, with the routine test module and the fast test module used for threshold prediction and the hearing screening module for identifying hearing loss. Results evaluated via cross-validation show that the routine test module and the fast test module predict hearing thresholds with similar performance from 0.5 to 8 kHz, with mean absolute errors of 7.06–11.61 dB for the routine module and of 7.40–12.60 dB for the fast module. However, the fast module involves less test time than is needed in the routine module. The hearing screening module identifies hearing status with a large area under the receiver operating characteristic curve (0.912–0.985), high accuracy (88.4–95.9%), and low false negative rate (2.9–7.0%) at 0.5–8 kHz. The three modules are further validated on unknown data, and the results are similar to those obtained through cross-validation, indicating these modules can be well generalized to new data. Both the routine module and fast module are potential tools for predicting hearing thresholds. However, their prediction performance in ears with hearing loss requires further improvement to facilitate their clinical utility. The hearing screening module shows promise as a clinical tool for identifying hearing loss.

It is of clinical interest to estimate pure-tone thresholds from potentially available objective measures, such as stimulus-frequency otoacoustic emissions (SFOAEs). SFOAEs can determine hearing status (normal hearing vs. hearing loss), but few studies have explored their further potential in predicting audiometric thresholds. The current study investigates the ability of SFOAEs to predict hearing thresholds at octave frequencies from 0.5 to 8 kHz. SFOAE input/output functions and pure-tone thresholds were measured from 230 ears with normal hearing and 737 ears with sensorineural hearing loss. Two methods were used to predict hearing thresholds. Method 1 is a linear regression model; Method 2 proposed in this study is a back propagation (BP) network predictor built on the bases of a BP neural network and principal component analysis. In addition, a BP network classifier was built to identify hearing status. Both Methods 1 and 2 were able to predict hearing thresholds from 0.5 to 8 kHz, but Method 2 achieved better performance than Method 1. The BP network classifiers achieved excellent performance in determining the presence or absence of hearing loss at all test frequencies. The results show that SFOAEs are not only able to identify hearing status with great accuracy at all test frequencies but, more importantly, can predict hearing thresholds at octave frequencies from 0.5 to 8 kHz, with best performance at 0.5 to 4 kHz. The BP network predictor is a potential tool for quantitatively predicting hearing thresholds, at least at 0.5 to 4 kHz.