Korda, Athanasia; Carey, John Patrick; Zamaro, Ewa; Caversaccio, Marco Domenico; Mantokoudis, Georgios (2020). How Good Are We in Evaluating a Bedside Head Impulse Test? Ear and hearing, 41(6), pp. 1747-1751. Wolters Kluwer Health 10.1097/AUD.0000000000000894
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OBJECTIVES
Clinicians performing a horizontal head impulse test (HIT) are looking for a corrective saccade. The detection of such saccades is a challenge. The aim of this study is to assess an expert's likelihood of detecting corrective saccades in subjects with vestibular hypofunction.
DESIGN
In a prospective cohort observational study at a tertiary referral hospital, we assessed 365 horizontal HITs performed clinically by an expert neurootologist from a convenience sample of seven patients with unilateral or bilateral deficient vestibulo-ocular reflex (VOR). All HITs were recorded simultaneously by video-oculography, as a gold standard. We evaluated saccades latency and amplitude, head velocity, and gain.
RESULTS
Saccade amplitude was statistically the most significant parameter for saccade detection (p < 0.001).The probability of saccade detection was eight times higher for HIT toward the pathological side (p = 0.029). In addition, an increase in saccade amplitude resulted in an increased probability of detection (odds ratio [OR] 1.77 [1.31 to 2.40] per degree, p < 0.001). The sensitivity to detect a saccade amplitude of 1 degree was 92.9% and specificity 79%. Saccade latency and VOR gain did not significantly influence the probability of the physician identifying a saccade (OR 1.02 [0.94 to 1.11] per 10-msec latency and OR 0.84 [0.60 to 1.17] per 0.1 VOR gain increase).
CONCLUSIONS
The saccade amplitude is the most important factor for accurate saccade detection in clinically performed head impulse tests. Contrary to current knowledge, saccade latency and VOR gain play a minor role in saccade detection.
Item Type: |
Journal Article (Original Article) |
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Division/Institute: |
04 Faculty of Medicine > Department of Head Organs and Neurology (DKNS) > Clinic of Ear, Nose and Throat Disorders (ENT) |
UniBE Contributor: |
Korda, Athanasia, Zamaro, Ewa, Caversaccio, Marco, Mantokoudis, Georgios |
Subjects: |
600 Technology > 610 Medicine & health |
ISSN: |
0196-0202 |
Publisher: |
Wolters Kluwer Health |
Language: |
English |
Submitter: |
Stefan Weder |
Date Deposited: |
13 Jan 2021 15:48 |
Last Modified: |
05 Dec 2022 15:43 |
Publisher DOI: |
10.1097/AUD.0000000000000894 |
PubMed ID: |
33136647 |
BORIS DOI: |
10.48350/150354 |
URI: |
https://boris.unibe.ch/id/eprint/150354 |
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