Inter-Rater Differences of Vor Gains Using Video Head Impulse Test: A Reliability Study.

Jennifer L Millar, Michael C Schubert, Yoav Gimmon

Research output: Contribution to conferencePoster

Abstract

Purpose/Hypothesis: The purpose of this study is to assess inter-rater reliability of the video head impulse test (vHIT). We hypothesized that there would be no differences in same day vHIT results by two examiners (E1 and E2) in patients with dizziness.

Number of Subjects: 35

Materials and Methods: To date, 35 patients have been tested with the vHIT (Otometrics, Natus) for assessment of VOR gain in each semicircular canal by two examiners within a single clinic visit. The reported VOR gains are based on the software analysis algorithm that uses the ‘area under the curve’ method. Each semicircular canal impulse plot was examined and “bad” trials (blink artifact, noise, an abnormally high gain, goggle slippage) were removed. 18 of the 35 subjects had at least one semicircular canal vHIT requiring the impulse data to be amended.

Results: Intra-class correlation (ICC) examined VOR gains between E1 and E2 for all 6 semicircular canal gains. Bland-Altman analysis examined the level of agreement between E1 and E2 (difference between examiners as a function of mean VOR differences between E1, E2) at 95% confidence intervals. Amplitude of passive head velocities (°/s) between examiners were determined using the paired samples t-test. ICC values between E1 and E2 reveal strong correlation for the horizontal (left HC 0.967; right HC 0.899) and LARP (LA 0.776; RP 0.863) semicircular canal gains, but weak to moderate correlations for RALP gains (RA 0.583, LP 0.709). We found a high level of agreement between examiners, although E2 achieved significantly higher mean gains in right posterior (p=0.002) and right anterior canals (p=0.013) Passive head velocities differed between examiners for the right horizontal (p =0.013), right posterior (p=0.026) and left posterior semicircular canals (p=0.04).

Conclusions: vHIT has good inter-rater reliability for the yaw and LARP plane with poor consistency in the RALP plane.

Clinical Relevance: vHIT has good inter-rater reliability for the yaw and LARP plane with poor consistency in the RALP plane among experienced and novice clinicians.
Original languageEnglish
StatePublished - 2020
EventAmerican Physical Therapy Association: Combined Sections Meeting - Colorado Convention Center , Denver, United States
Duration: 12 Feb 202015 Feb 2020

Conference

ConferenceAmerican Physical Therapy Association
Country/TerritoryUnited States
CityDenver
Period12/02/2015/02/20

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