Interobserver agreement in BPPV diagnosis using eye movement recordings.
Ali A Melliti1, Rajneesh Bhandari2, Anita Bhandari3
1Division of Vestibular Disorders, Department of Otorhinolaryngology and Head & Neck Surgery, School for Mental Health and Neuroscience, Maastricht University Medical Center, Maastricht, 6229 HX, The Netherlands. ali.melliti@mumc.nl.
Scientific Reports
|August 17, 2025
Summary
Interobserver agreement for diagnosing Benign Paroxysmal Positional Vertigo (BPPV) using eye movement recordings was fair to moderate. Incorporating patient history and symptoms could improve diagnostic accuracy in telemedicine settings.
Area of Science:
- Neurology
- Otolaryngology
- Vestibular Science
Background:
- Benign Paroxysmal Positional Vertigo (BPPV) is a common peripheral vestibular disorder.
- Despite effective treatments, BPPV diagnosis faces delays and high healthcare costs.
- Telemedicine could enhance diagnostic accessibility and efficiency for BPPV.
Purpose of the Study:
- To assess the interobserver agreement among specialists in diagnosing BPPV using eye movement recordings.
- To evaluate intraobserver agreement for diagnostic consistency.
Main Methods:
- Six specialists evaluated 240 BPPV patient video recordings.
- Interobserver and intraobserver agreement were calculated using Cohen's kappa and proportion of agreement.
- Agreement with original diagnoses was also assessed.
Main Results:
- Interobserver agreement was fair to moderate (Cohen's kappa = 0.40).
- Intraobserver agreement varied from fair to almost perfect among specialists.
- Agreement with original diagnoses ranged from fair to substantial.
Conclusions:
- Interobserver agreement for BPPV diagnosis via eye movement recordings is fair to moderate.
- Suboptimal agreement may stem from missing clinical information like patient history and symptoms.
- Future research should include comprehensive clinical data to improve diagnostic agreement.
