This article discusses an important and well-known point regarding the differences between coupler sound pressure measurements, used to calibrate earphones, and actual pressures delivered to the ear due to individual variances across patients. The study purports to suggest a new clinical tool; however, there is not sufficient definition of a number of key points, e.g. how is the ‘forward-going’ sound pressure wave defined? There are a number of methodological points that were not provided to help interpret the results in a meaningful way and the use of parametric statistical tests for non-parametric data raises some concern. While there may be some value to the use of a forward-going sound pressure wave, this article does not demonstrate the clinical utility with sufficient clarity to justify a wholesale change in the modus operandi for diagnostic or rehabilitative benefit. The article is worth reading as the introduction defines the issue well; however, the method needs considerable work before becoming a clinical tool.