Helen S Cohen1, Jasmine Stitz2, Haleh Sangi-Haghpeykar3, Susan P Williams4, Ajitkumar P Mulavara5, Brian T Peters5, Jacob J Bloomberg6. 1. a Bobby R Alford Department of Otolaryngology-Head and Neck Surgery , Baylor College of Medicine , Houston , TX , USA. 2. b Department of Medical Engineering , University of Applied Sciences/Upper Austria , Linz , Austria. 3. c Department of Obstetrics and Gynecology , Baylor College of Medicine , Houston , TX , USA. 4. d Department of Medicine , Baylor College of Medicine , Houston , TX , USA. 5. e KBRwyle , Houston , TX , USA. 6. f NASA/Johnson Space Center , Neuroscience Research Laboratories , Houston , TX , USA.
Abstract
OBJECTIVE: The goal of this study was to determine the sensitivity and specificity of some widely used, easily administered clinical tests. BACKGROUND: Simple tests of oculomotor function have become widely used for clinical screening of patients suspected of having vestibular disorders despite a paucity of evidence showing good statistical support for their use in this highly variable population. METHODS: Healthy controls with no history of otologic or neurologic disorders (n = 291) were compared to patients with known vestibular disorders (n = 62). All subjects performed passive and active head shaking, un-instrumented head impulse tests (HT), and video head impulse tests (vHIT) recorded with infrared video-oculography. RESULTS: For both passive and active head shaking, using presence/absence of vertigo and of nystagmus, sensitivity was low (<0.40). Sensitivity of presence/absence of saccades on HT was even lower (<0.15). On vHIT, gains were all approximately = 1.0, so sensitivity was very low (approximately 0.15-0.35). Sensitivity and specificity for presence/absence of saccades were moderately poor (less than 0.70). CONCLUSION: None of these tests are adequate for screening patients in the out-patient clinic for vestibular disorders or for screening people in epidemiologic studies to determine the prevalence of vestibular disorders.
OBJECTIVE: The goal of this study was to determine the sensitivity and specificity of some widely used, easily administered clinical tests. BACKGROUND: Simple tests of oculomotor function have become widely used for clinical screening of patients suspected of having vestibular disorders despite a paucity of evidence showing good statistical support for their use in this highly variable population. METHODS: Healthy controls with no history of otologic or neurologic disorders (n = 291) were compared to patients with known vestibular disorders (n = 62). All subjects performed passive and active head shaking, un-instrumented head impulse tests (HT), and video head impulse tests (vHIT) recorded with infrared video-oculography. RESULTS: For both passive and active head shaking, using presence/absence of vertigo and of nystagmus, sensitivity was low (<0.40). Sensitivity of presence/absence of saccades on HT was even lower (<0.15). On vHIT, gains were all approximately = 1.0, so sensitivity was very low (approximately 0.15-0.35). Sensitivity and specificity for presence/absence of saccades were moderately poor (less than 0.70). CONCLUSION: None of these tests are adequate for screening patients in the out-patient clinic for vestibular disorders or for screening people in epidemiologic studies to determine the prevalence of vestibular disorders.
Entities:
Keywords:
Vestibulo-ocular reflex; head impulse test; head shaking; infra-red video-oculography; video head impulse test
Authors: S Vanni; R Pecci; C Casati; F Moroni; M Risso; M Ottaviani; P Nazerian; S Grifoni; P Vannucchi Journal: Acta Otorhinolaryngol Ital Date: 2014-12 Impact factor: 2.124
Authors: Leigh A McGarvie; Hamish G MacDougall; G Michael Halmagyi; Ann M Burgess; Konrad P Weber; Ian S Curthoys Journal: Front Neurol Date: 2015-07-08 Impact factor: 4.003