Comparison of test results from two separate video head impulse test systems in a cohort of patients diagnosed with a un
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Comparison of test results from two separate video head impulse test systems in a cohort of patients diagnosed with a unilateral vestibular schwannoma Mathilde Aalling1 · Regitze Kuhr Skals2 · Emil Riis Abrahamsen1 · Dan Dupont Hougaard1,3 Received: 12 April 2020 / Accepted: 6 June 2020 © Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract Purpose Video head impulse testing (vHIT) is a relatively new technology enabling evaluation of vestibular function. The aim of this study was to compare the test results from two separate vHIT systems in a group of patients diagnosed with a unilateral vestibular schwannoma (VS) with regards to sensitivity, specificity and inter-examiner differences. Methods Forty-two patients were examined with two separate vHIT systems: E yeSeeCam® (system A) and ICS I mpulse® (system B), by one of two examiners. All six semicircular canals (SCCs) were tested under standardized conditions, and strict criteria were set up for post-test interpretation. Results With the majority of test parameters, the two test systems were in agreement. Vestibular deficits were found in 40.5% (system A) to 45% (system B) of patients with a VS on the tested side; corresponding to a positive predictive value (PPV) of 86.4% (system B) to 94.4% (system A). The specificity was 97.6% for system A and 92.9% for system B. An overall agreement between the two vHIT systems measured as kappa was computed to be 0.61. There were no significant inter-examiner differences. When testing the vertical SCCs, a tendency of too high mean gain values was seen with system A but not with system B. Conclusion In patients with unilateral VS, vHIT is a test with moderate sensitivity and high specificity in regard to identification of a vestibular deficit. There were no significant differences in test results between the two vHIT systems. Keywords Video head impulse test · vHIT · Vestibular schwannoma · Vestibular function · Test agreement · Sensitivity
Background Video head impulse test
Electronic supplementary material The online version of this article (https://doi.org/10.1007/s00405-020-06116-2) contains supplementary material, which is available to authorized users. * Mathilde Aalling [email protected] 1
Department of Otolaryngology, Head and Neck Surgery and Audiology, Aalborg University Hospital, Aalborg, Denmark
2
Unit of Clinical Biostatistics and Bioinformatics, Aalborg University Hospital, Aalborg, Denmark
3
Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
Video head impulse testing (vHIT) enables evaluation of the vestibulo-ocular reflex (VOR) by means of measuring the speed of the correctional eye movement that occurs in response to fast passive head turn conducted while the patient looks at an earth fixed target. All six semicircular canals (SCCs) may be evaluated separately by turning the head in three different planes corresponding to the orientation of the three paired SSCs. The lightweight goggles worn by the patient, register both peak head v
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