Evaluation of Interexaminer Variability in Video Head Impulse Test Results
Objective The video head impulse test (vHIT) is a diagnostic tool to assess the function of the semicircular canals and branches of the vestibular nerve. The aim of this study was to analyze the interexaminer variability of vHIT results in healthy subjects.
Materials and Methods A total of 21 healthy participants were included in the study. vHIT responses were collected by four clinicians. Variability of the vHIT results between examiners was analyzed statistically.
Results The vestibulo-ocular reflex (VOR) velocity regression values were from 0.99 to 1.09 degrees per second for the lateral canals. For the vertical canals, VOR velocity regression values were from 0.87 to 1.21 degrees per second. According to repeated measures analysis of variance, the normality assumptions for the velocity regression of the left lateral canal (p = 0.002) and the right anterior canal (p < 0.01) were met and the differences were statistically significant. The normality assumptions were not met for 40, 60, and 80 ms median gain of the right lateral canal (p = 0.016, p = 0.038, and p = 0.001, respectively); 40 and 60 ms median gain of the left lateral canal (p < 0.001 and p = 0.008, respectively); and the velocity regression of the left posterior canal (p < 0.00). These differences were found to be statistically significant by using the Friedman test.
Conclusion The interexaminer differences of the VOR gain values for the vHIT were statistically significant. Serial vHIT testing should be performed by the same examiner to reduce the effects of interexaminer variability.
Eingereicht: 06. März 2019
Angenommen: 22. Februar 2020
20. Oktober 2020 (online)
© 2020. American Academy of Audiology. This article is published by Thieme.
Thieme Medical Publishers, Inc.
333 Seventh Avenue, 18th Floor, New York, NY 10001, USA
- 1 Kroenke K, Price RK. Symptoms in the community. Prevalence, classification, and psychiatric comorbidity. Arch Intern Med 1993; 153 (21) 2474-2480
- 2 Neuhauser HK, von Brevern M, Radtke A. et al. Epidemiology of vestibular vertigo: a neurotologic survey of the general population. Neurology 2005; 65 (06) 898-904
- 3 Radtke A, Lempert T, Gresty MA, Brookes GB, Bronstein AM, Neuhauser H. Migraine and Ménière's disease: is there a link?. Neurology 2002; 59 (11) 1700-1704
- 4 Ahmed MFM. Rotational chair testing in patients with unilateral peripheral vestibular disorders. Egypt J Otolaryngol 2015; 31 (02) 115-121
- 5 Barin K. Background and Technique of Caloric Testing. In: Jacobson GP, Shepard NT. eds. Balance Function Assessment and Management. 2nd ed.. San Diego, CA: Plural Publishing; 2016: 283-319
- 6 Cullen KE, Roy JE. Signal processing in the vestibular system during active versus passive head movements. J Neurophysiol 2005; 93: 1820-1820
- 7 Halmagyi GM, Curthoys IS. A clinical sign of canal paresis. Arch Neurol 1988; 45 (07) 737-739
- 8 Weber KP, MacDougall HG, Halmagyi GM, Curthoys IS. Impulsive testing of semicircular-canal function using video-oculography. Ann N Y Acad Sci 2009; 1164: 486-491
- 9 Wong AM, Sharpe JA, Tweed D. The vestibulo-ocular reflex in fourth nerve palsy: deficits and adaptation. Vision Res 2002; 42 (18) 2205-2218
- 10 Alhabib SF, Saliba I. Video head impulse test: a review of the literature. Eur Arch Otorhinolaryngol 2017; 274 (03) 1215-1222
- 11 MacDougall HG, Weber KP, McGarvie LA, Halmagyi GM, Curthoys IS. The video head impulse test: diagnostic accuracy in peripheral vestibulopathy. Neurology 2009; 73 (14) 1134-1141
- 12 Macdougall HG, McGarvie LA, Halmagyi GM, Curthoys IS, Weber KP. The video head impulse test (vHIT) detects vertical semicircular canal dysfunction. PLoS One 2013; 8 (04) e61488
- 13 MacDougall HG, McGarvie LA, Halmagyi GM, Curthoys IS, Weber KP. Application of the video head impulse test to detect vertical semicircular canal dysfunction. Otol Neurotol 2013; 34 (06) 974-979
- 14 Ross LM, Helminski JO. Test-retest and interrater reliability of the video head impulse test in the pediatric population. Otol Neurotol 2016; 37 (05) 558-563
- 15 McCaslin DL, Jacobson GP, Bennett ML, Gruenwald JM, Green AP. Predictive properties of the video head impulse test: measures of caloric symmetry and self-report dizziness handicap. Ear Hear 2014; 35 (05) e185-e191
- 16 Bartl K, Lehnen N, Kohlbecher S, Schneider E. Head impulse testing using video-oculography. Ann N Y Acad Sci 2009; 1164 (01) 331-333
- 17 Patterson JN, Bassett AM, Mollak CM, Honaker JA. Effects of hand placement technique on the video head impulse test (vHIT) in younger and older adults. Otol Neurotol 2015; 36 (06) 1061-1068
- 18 Suh M-W, Park JH, Kang SI, Lim JH, Park MK, Kwon SK. Effect of goggle slippage on the video head impulse test outcome and its mechanisms. Otol Neurotol 2017; 38 (01) 102-109
- 19 Curthoys IS, Macdougall HG, McGarvie LA. et al. The video head impulse test (vHIT). In: Jacobson GP, Shepard NT. eds. Balance Function Assessment and Management. 2nd ed.. San Diego, CA: Plural Publishing; 2016: 391-430
- 20 Blödow A, Blödow J, Bloching MB, Helbig R, Walther LE. Horizontal VOR function shows frequency dynamics in vestibular schwannoma. Eur Arch Otorhinolaryngol 2015; 272 (09) 2143-2148
- 21 Koo TK, Li MY. A guideline of selecting and reporting intraclass correlation coefficients for reliability research. J Chiropr Med 2016; 15 (02) 155-163
- 22 Ahadi M, Rezazadeh N, Pourbakht A. Comparison of vestibulo-ocular reflex instantaneous gain and velocity regression in differentiating the peripheral vestibular disorders. Aud Vest Res 2017; 26 (04) 195-201
- 23 Blödow A, Helbig R, Wichmann N, Bloching M, Walther LE. The video head impulse test: first clinical experiences [in German]. HNO 2013; 61 (04) 327-334
- 24 Blödow A, Helbig R, Wichmann N, Wenzel A, Walther LE, Bloching MB. Video head impulse test or caloric irrigation? Contemporary diagnostic tests for vestibular schwannoma [in German]. HNO 2013; 61 (09) 781-785
- 25 Naderi N, Hajiabolhassan F, Farahani S, Yazdani N, Jalaie S. Normative vestibulo-ocular reflex data in yaw and pitch axes using the video head-impulse test. Aud Vest Res 2016; 25 (01) 39-48
- 26 Hirvonen M, Aalto H, Migliaccio AA, Hirvonen TP. Motorized head impulse rotator for horizontal vestibulo-ocular reflex: normal responses. Arch Otolaryngol Head Neck Surg 2007; 133 (02) 157-161
- 27 Wiener-Vacher SR, Wiener SI. Video head impulse tests with a remote camera system: normative values of semicircular canal vestibulo-ocular reflex gain in infants and children. Front Neurol 2017; 8 (434) 434
- 28 Bansal S, Sinha SK. Assessment of VOR gain function and its test-retest reliability in normal hearing individuals. Eur Arch Otorhinolaryngol 2016; 273 (10) 3167-3173
- 29 McGarvie LA, MacDougall HG, Halmagyi GM, Burgess AM, Weber KP, Curthoys IS. The video head impulse test (vHIT) of semicircular canal function–age-dependent normative values of VOR gain in healthy subjects. Front Neurol 2015; 6: 154
- 30 Murnane O, Mabrey H, Pearson A, Byrd S, Akin F. Normative data and test-retest reliability of the SYNAPSYS video head impulse test. J Am Acad Audiol 2014; 25 (03) 244-252
- 31 Korsager LEH, Schmidt JH, Faber C, Wanscher JH. Reliability and comparison of gain values with occurrence of saccades in the EyeSeeCam video head impulse test (vHIT). Eur Arch Otorhinolaryngol 2016; 273 (12) 4273-4279
- 32 Weber KP, MacDougall HG, McGarvie LA. et al. The video head impulse test: diagnostic accuracy in peripheral vestibulopathy. Neurology 2010; 74: A386
- 33 Jacobsen CL, Abrahamsen ER, Skals RK, Hougaard DD. Is Regression Gain or Instantaneous Gain the most reliable and reproducible gain value when performing video Head Impulse Testing of the lateral semicircular canals?. In 31st Politzer Society Meeting & 2nd Global Otology Research Forum; 2018