Triple test as predictive screen for unilateral weakness on caloric testing in routine practice
To investigate in vertigo patients in routine practice to what extent a rapid and straightforward triple bedside test (spontaneous nystagmus, head-shaking nystagmus, and the head impulse test) can predict a normal result on caloric testing. Prospective, single-blind, diagnostic study. Tertiary refer...
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| Veröffentlicht in: | Otology & neurotology 2013-02, Vol.34 (2), p.297-303 |
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| container_title | Otology & neurotology |
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| creator | Rohrmeier, Christian Richter, Otto Schneider, Michael Wirsching, Kornelia Fiedler, Isabella Haubner, Frank Strutz, Jürgen Kühnel, Thomas S |
| description | To investigate in vertigo patients in routine practice to what extent a rapid and straightforward triple bedside test (spontaneous nystagmus, head-shaking nystagmus, and the head impulse test) can predict a normal result on caloric testing.
Prospective, single-blind, diagnostic study.
Tertiary referral center.
151 patients (78 male and 73 female subjects; mean age, 52.5 +/- 16.4 yr) presenting with acute or recent symptoms of vertigo.
Diagnostic evaluation.
The negative predictive value (NPV) of the triple test in relation to a normal caloric test response.
In unilateral weakness (UW) on caloric testing (UW, >=25%), the triple test had sensitivity of 63.6%, specificity of 85.4%, a positive predictive value (PPV) of 71.4%, and an NPV of 80.4%. In other words, 80.4% of patients with a negative triple test also had a normal response on caloric testing. In pronounced canal paresis (UW, >=50%), the triple test had sensitivity of 81.8%, specificity of 81.4%, a PPV of 55.1%, and an NPV of 94.1%. Significant differences were found between 2 subgroups assessed by examiners with differing levels of experience (p < 0.05).
The triple test represents a good screening tool that quickly and reliably excludes unilateral weakness and in particular pronounced canal paresis on caloric testing. |
| doi_str_mv | 10.1097/MAO.0b013e31827d0901 |
| format | Article |
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Prospective, single-blind, diagnostic study.
Tertiary referral center.
151 patients (78 male and 73 female subjects; mean age, 52.5 +/- 16.4 yr) presenting with acute or recent symptoms of vertigo.
Diagnostic evaluation.
The negative predictive value (NPV) of the triple test in relation to a normal caloric test response.
In unilateral weakness (UW) on caloric testing (UW, >=25%), the triple test had sensitivity of 63.6%, specificity of 85.4%, a positive predictive value (PPV) of 71.4%, and an NPV of 80.4%. In other words, 80.4% of patients with a negative triple test also had a normal response on caloric testing. In pronounced canal paresis (UW, >=50%), the triple test had sensitivity of 81.8%, specificity of 81.4%, a PPV of 55.1%, and an NPV of 94.1%. Significant differences were found between 2 subgroups assessed by examiners with differing levels of experience (p < 0.05).
The triple test represents a good screening tool that quickly and reliably excludes unilateral weakness and in particular pronounced canal paresis on caloric testing.</description><identifier>ISSN: 1531-7129</identifier><identifier>EISSN: 1537-4505</identifier><identifier>DOI: 10.1097/MAO.0b013e31827d0901</identifier><identifier>PMID: 23444477</identifier><language>eng</language><publisher>United States</publisher><subject>Adult ; Aged ; Algorithms ; Caloric Tests - methods ; Female ; Head Movements - physiology ; Humans ; Male ; Middle Aged ; Neurologic Examination - methods ; Nystagmus, Pathologic - diagnosis ; Otolaryngology - methods ; Point-of-Care Systems ; Predictive Value of Tests ; Vertigo - diagnosis ; Vestibular Diseases - diagnosis ; Vestibular Function Tests</subject><ispartof>Otology & neurotology, 2013-02, Vol.34 (2), p.297-303</ispartof><rights>(C) 2013 Otology & Neurotology, Inc.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c307t-e233efd5bf0e785a7ac52fbc0ba35e196f9ae526b53e7111549200a34e426c203</citedby><cites>FETCH-LOGICAL-c307t-e233efd5bf0e785a7ac52fbc0ba35e196f9ae526b53e7111549200a34e426c203</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,27901,27902</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/23444477$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Rohrmeier, Christian</creatorcontrib><creatorcontrib>Richter, Otto</creatorcontrib><creatorcontrib>Schneider, Michael</creatorcontrib><creatorcontrib>Wirsching, Kornelia</creatorcontrib><creatorcontrib>Fiedler, Isabella</creatorcontrib><creatorcontrib>Haubner, Frank</creatorcontrib><creatorcontrib>Strutz, Jürgen</creatorcontrib><creatorcontrib>Kühnel, Thomas S</creatorcontrib><title>Triple test as predictive screen for unilateral weakness on caloric testing in routine practice</title><title>Otology & neurotology</title><addtitle>Otol Neurotol</addtitle><description>To investigate in vertigo patients in routine practice to what extent a rapid and straightforward triple bedside test (spontaneous nystagmus, head-shaking nystagmus, and the head impulse test) can predict a normal result on caloric testing.
Prospective, single-blind, diagnostic study.
Tertiary referral center.
151 patients (78 male and 73 female subjects; mean age, 52.5 +/- 16.4 yr) presenting with acute or recent symptoms of vertigo.
Diagnostic evaluation.
The negative predictive value (NPV) of the triple test in relation to a normal caloric test response.
In unilateral weakness (UW) on caloric testing (UW, >=25%), the triple test had sensitivity of 63.6%, specificity of 85.4%, a positive predictive value (PPV) of 71.4%, and an NPV of 80.4%. In other words, 80.4% of patients with a negative triple test also had a normal response on caloric testing. In pronounced canal paresis (UW, >=50%), the triple test had sensitivity of 81.8%, specificity of 81.4%, a PPV of 55.1%, and an NPV of 94.1%. Significant differences were found between 2 subgroups assessed by examiners with differing levels of experience (p < 0.05).
The triple test represents a good screening tool that quickly and reliably excludes unilateral weakness and in particular pronounced canal paresis on caloric testing.</description><subject>Adult</subject><subject>Aged</subject><subject>Algorithms</subject><subject>Caloric Tests - methods</subject><subject>Female</subject><subject>Head Movements - physiology</subject><subject>Humans</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Neurologic Examination - methods</subject><subject>Nystagmus, Pathologic - diagnosis</subject><subject>Otolaryngology - methods</subject><subject>Point-of-Care Systems</subject><subject>Predictive Value of Tests</subject><subject>Vertigo - diagnosis</subject><subject>Vestibular Diseases - diagnosis</subject><subject>Vestibular Function Tests</subject><issn>1531-7129</issn><issn>1537-4505</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2013</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpdkM1OwzAQhC0EoqXwBgj5yCXF643r5lhV_ElFvZSz5TgbZEiTYCcg3p7QFg7sZecwM7v6GLsEMQWR6ZunxXoqcgFICHOpC5EJOGJjUKiTVAl1vNOQaJDZiJ3F-CoEaFT6lI0kpsNoPWZmE3xbEe8odtxG3gYqvOv8B_HoAlHNyybwvvaV7SjYin-SfaspRt7U3NmqCd7twr5-4b7moekHSUOPHVocnbOT0laRLg57wp7vbjfLh2S1vn9cLlaJQ6G7hCQilYXKS0F6rqy2TskydyK3qAiyWZlZUnKWKyQNACrNpBAWU0rlzEmBE3a9721D894P_5itj46qytbU9NEAAqYSUOFgTfdWF5oYA5WmDX5rw5cBYX7QmgGt-Y92iF0dLvT5loq_0C9L_Abv_nZE</recordid><startdate>201302</startdate><enddate>201302</enddate><creator>Rohrmeier, Christian</creator><creator>Richter, Otto</creator><creator>Schneider, Michael</creator><creator>Wirsching, Kornelia</creator><creator>Fiedler, Isabella</creator><creator>Haubner, Frank</creator><creator>Strutz, Jürgen</creator><creator>Kühnel, Thomas S</creator><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>201302</creationdate><title>Triple test as predictive screen for unilateral weakness on caloric testing in routine practice</title><author>Rohrmeier, Christian ; Richter, Otto ; Schneider, Michael ; Wirsching, Kornelia ; Fiedler, Isabella ; Haubner, Frank ; Strutz, Jürgen ; Kühnel, Thomas S</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c307t-e233efd5bf0e785a7ac52fbc0ba35e196f9ae526b53e7111549200a34e426c203</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2013</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Algorithms</topic><topic>Caloric Tests - methods</topic><topic>Female</topic><topic>Head Movements - physiology</topic><topic>Humans</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Neurologic Examination - methods</topic><topic>Nystagmus, Pathologic - diagnosis</topic><topic>Otolaryngology - methods</topic><topic>Point-of-Care Systems</topic><topic>Predictive Value of Tests</topic><topic>Vertigo - diagnosis</topic><topic>Vestibular Diseases - diagnosis</topic><topic>Vestibular Function Tests</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Rohrmeier, Christian</creatorcontrib><creatorcontrib>Richter, Otto</creatorcontrib><creatorcontrib>Schneider, Michael</creatorcontrib><creatorcontrib>Wirsching, Kornelia</creatorcontrib><creatorcontrib>Fiedler, Isabella</creatorcontrib><creatorcontrib>Haubner, Frank</creatorcontrib><creatorcontrib>Strutz, Jürgen</creatorcontrib><creatorcontrib>Kühnel, Thomas S</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Otology & neurotology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Rohrmeier, Christian</au><au>Richter, Otto</au><au>Schneider, Michael</au><au>Wirsching, Kornelia</au><au>Fiedler, Isabella</au><au>Haubner, Frank</au><au>Strutz, Jürgen</au><au>Kühnel, Thomas S</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Triple test as predictive screen for unilateral weakness on caloric testing in routine practice</atitle><jtitle>Otology & neurotology</jtitle><addtitle>Otol Neurotol</addtitle><date>2013-02</date><risdate>2013</risdate><volume>34</volume><issue>2</issue><spage>297</spage><epage>303</epage><pages>297-303</pages><issn>1531-7129</issn><eissn>1537-4505</eissn><abstract>To investigate in vertigo patients in routine practice to what extent a rapid and straightforward triple bedside test (spontaneous nystagmus, head-shaking nystagmus, and the head impulse test) can predict a normal result on caloric testing.
Prospective, single-blind, diagnostic study.
Tertiary referral center.
151 patients (78 male and 73 female subjects; mean age, 52.5 +/- 16.4 yr) presenting with acute or recent symptoms of vertigo.
Diagnostic evaluation.
The negative predictive value (NPV) of the triple test in relation to a normal caloric test response.
In unilateral weakness (UW) on caloric testing (UW, >=25%), the triple test had sensitivity of 63.6%, specificity of 85.4%, a positive predictive value (PPV) of 71.4%, and an NPV of 80.4%. In other words, 80.4% of patients with a negative triple test also had a normal response on caloric testing. In pronounced canal paresis (UW, >=50%), the triple test had sensitivity of 81.8%, specificity of 81.4%, a PPV of 55.1%, and an NPV of 94.1%. Significant differences were found between 2 subgroups assessed by examiners with differing levels of experience (p < 0.05).
The triple test represents a good screening tool that quickly and reliably excludes unilateral weakness and in particular pronounced canal paresis on caloric testing.</abstract><cop>United States</cop><pmid>23444477</pmid><doi>10.1097/MAO.0b013e31827d0901</doi><tpages>7</tpages></addata></record> |
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| source | MEDLINE; Journals@Ovid Complete |
| subjects | Adult Aged Algorithms Caloric Tests - methods Female Head Movements - physiology Humans Male Middle Aged Neurologic Examination - methods Nystagmus, Pathologic - diagnosis Otolaryngology - methods Point-of-Care Systems Predictive Value of Tests Vertigo - diagnosis Vestibular Diseases - diagnosis Vestibular Function Tests |
| title | Triple test as predictive screen for unilateral weakness on caloric testing in routine practice |
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