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Subjective Visual Vertical Evaluation by a Smartphone-based Test-Taking the Phone Out of the Bucket
Anat Wengier1, Omer J Ungar, Ophir Handzel
1Department of Otolaryngology-Head and Neck Surgery and Maxillofacial Surgery, Tel-Aviv Sourasky Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
Objective:
To measure the subjective visual vertical (SVV) in patients suffering from peripheral vestibular disorders versus controls, using a smartphone-based test designed to simulate the bucket test, in order to validate it as an available tool for the clinician.
Study Design:
Prospective cohort study.
Setting:
Academic tertiary medical center.
Patients:
Forty-five adult patients were recruited to the study, 25 had vestibular disorders, and 20 did not (controls).
Intervention:
All patients underwent conventional bucket-SVV (b-SVV) and smartphone-based SVV (s-SVV) testing.
Main Outcome Measures:
Correlation and agreement of b-SVV and s-SVV scores in patients with peripheral vestibular disorders compared to controls.
Results:
SVV score in the vestibular disorders group was significantly higher compared to controls in both testing methods (p < 0.001 for b-SVV and p = 0.01 for s-SVV, effect size d = 1.7 for both testing methods). Intragroup correlation was excellent within the study group. Spearman's rank correlation coefficient between b-SVV and s-SVV was 0.902 (p = 0.01). Agreement measurements suggested a greater sensitivity for the b-SVV test, showing a mean difference of 1.088 degree (SD ± 1.77); directionality, however, was preserved.
Conclusion:
The smartphone-based test is a valid, simple, and efficient in-office screening tool for assisting in the diagnosis of vestibular disorders.
