The Head Impulse Test as a Predictor of Videonystagmography Caloric Test Lateralization According to the Level of Examiner Experience: A Prospective Open-Label Study
| Autor: | Ashraf Awadie, Avi Shupak, Margalit Kaminer, Yehuda Holdstein |
|---|---|
| Rok vydání: | 2018 |
| Předmět: |
Adult
Male medicine.medical_specialty Video Recording Audiology Caloric test Sensitivity and Specificity Lateralization of brain function Young Adult 03 medical and health sciences 0302 clinical medicine Predictive Value of Tests Caloric Tests Humans Medicine Videonystagmography Prospective Studies 030223 otorhinolaryngology Prospective cohort study Head Impulse Test Vestibular Neuronitis Aged Aged 80 and over medicine.diagnostic_test business.industry Electronystagmography Caloric theory Head impulse test Middle Aged Otorhinolaryngology Predictive value of tests Ambulatory Female Clinical Competence business 030217 neurology & neurosurgery |
| Zdroj: | Ear, Nose & Throat Journal. 97:16-23 |
| ISSN: | 1942-7522 0145-5613 |
| DOI: | 10.1177/0145561318097001-222 |
| Popis: | We conducted a study to compare how well the head impulse test (HIT), without and with eye-movement recordings, would predict videonystagmographic (VNG) caloric test lateralization when performed by a resident and an experienced otoneurologist. This prospective, open-label, blinded study was conducted in an ambulatory tertiary care referral center. Our study population was made up of 60 patients–29 men and 31 women, aged 20 to 82 years (mean: 56.4 ± 11.4)—with peripheral vestibulopathy who underwent HIT and VNG caloric testing. The HIT was conducted in two protocols: HITO and HIT1. The HITO was performed with passive brisk movements of the patient's head from the 0° null position to 20° sideways, and the HIT1 was performed toward the center while the null position was a 20° head rotation to the right and to the left. Each protocol was carried out without video eye-movement recordings (HITO and HIT1) and with such recordings (rHITO and rHITl). The primary outcome measures were (1) a comparison of the HIT's sensitivity and specificity when performed by the resident and by the experienced otoneurologist and (2) the ability of video-recorded HIT to predict VNG caloric test lateralization. The sensitivity and specificity obtained by the resident were 41 and 81 %, respectively, for HITO and 41 and 90% for HIT1. The sensitivity and specificity obtained by the experienced otoneurologist were 18 and 89% for HITO and 32 and 85% for HIT1. Analysis of the recorded eye-movement clips of the HITO and HITl obtained by a second experienced otoneurologist found a sensitivity and specificity of 32 and 63% for rHITO and 33 and 82% for rHIT1. We conclude that the HIT yields high false-negative rates in predicting significant caloric lateralization. Analysis of the eye-movement recordings was no better than normal testing alone for detecting saccades. The experience of the examining physician had no impact on test performance characteristics. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|