In this four year prospective study, extratympanic electrocochleogram results and patient symptoms using the AAO-HNS criteria for Meniere’s disease were analyzed. Clinical decision analysis included 164 subject data sets (328 ears) revealed that comparing the SP/AP ratio in both ears was more powerful than past reporting techniques of reviewing absolute amplitudes, reviewing the ears separately. Soon a paper is to be submitted outlining a new way to report Ecog results, which gives the managing Otologist a corresponding false-positive and hit-rate for Meniere’s disease for each individual patient result.