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Reliability and diagnostic accuracy of clinical tests of vestibular function for children
Jennifer B Christy1, JoAnne Payne, Andres Azuero
1Department of Physical Therapy, School of Health Professions (Dr Christy), and Department of Community Health, Outcomes and Systems, School of Nursing (Dr Azuero), The University of Alabama at Birmingham, Birmingham, Alabama; Department of Communicative Disorders (Ms Payne and Dr Formby), College of Arts and Sciences, The University of Alabama, Tuscaloosa, Alabama.
Insights
Pediatric vestibular function tests show high reliability and diagnostic accuracy. These clinical assessments effectively identify children experiencing vestibular hypofunction, aiding in early diagnosis and intervention.
Area of Science:
- Pediatric audiology and vestibular science.
- Clinical neurophysiology and balance assessment.
Background:
- Vestibular hypofunction in children can impact development and quality of life.
- Accurate and reliable clinical tests are crucial for diagnosing pediatric vestibular disorders.
Purpose of the Study:
- To evaluate the reliability and diagnostic accuracy of pediatric clinical vestibular tests.
- To determine the minimal detectable change (MDC90) for key vestibular assessments in children.
Main Methods:
- Assessed reliability and diagnostic values of six clinical vestibular tests in children with hearing loss and typically developing children.
- Utilized reference standards including rotary chair and vestibular evoked myogenic potential tests.
- Calculated intraclass correlation coefficients, sensitivity, specificity, predictive values, and MDC90 scores.
Main Results:
- Reliability (intraclass correlation coefficient) ranged from 0.73 to 0.95 across tests.
- Sensitivity and specificity values varied from 63% to 100%.
- MDC90 values were established for Dynamic Visual Acuity and Modified Clinical Test of Sensory Interaction on Balance.
Conclusions:
- Pediatric clinical vestibular tests demonstrate strong reliability and diagnostic capabilities.
- These tests are effective tools for identifying vestibular hypofunction in children.
Purpose:
To determine reliability, diagnostic values, and minimal detectable change scores, 90% confidence (MDC90) of pediatric clinical tests of vestibular function.
Methods:
Twenty children with severe to profound bilateral sensorineural hearing loss and 23 children with typical development, aged 6 to 12 years, participated. The Head Thrust Test, Emory Clinical Vestibular Chair Test, Bucket Test, Dynamic Visual Acuity, Modified Clinical Test of Sensory Interaction on Balance, and Sensory Organization Test were completed twice for reliability. Reference standard diagnostic tests were rotary chair and vestibular evoked myogenic potential. Reliability, sensitivity, specificity, predictive values, likelihood ratios, and MDC90 scores were calculated.
Results:
Reliability ranged from an intraclass correlation coefficient of 0.73 to 0.95. Sensitivity, specificity, and predictive values, using cutoff scores for each test representing the largest area under the curve, ranged from 63% to 100%. The MDC90 for Dynamic Visual Acuity and Modified Clinical Test of Sensory Interaction on Balance were 8 optotypes and 16.75 seconds, respectively.
Conclusions:
Clinical tests can be used accurately to identify children with vestibular hypofunction.
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