Department of Otorhinolaryngology, University of Regensburg, Franz-Josef-Strauss-Allee 11, Regensburg, Germany.
Otol Neurotol. 2013 Feb;34(2):297-303. doi: 10.1097/mao.0b013e31827d0901.
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.
在常规实践中调查眩晕患者，快速而直接的三 bedside 测试（自发性眼球震颤、摇头眼球震颤和眼球脉冲试验）在多大程度上可以预测热刺激试验的正常结果。
前瞻性、单盲、诊断研究。
三级转诊中心。
151 名患者（78 名男性和 73 名女性；平均年龄，52.5 +/- 16.4 岁）出现急性或近期眩晕症状。
诊断评估。
三 test 在正常热刺激试验反应方面的阴性预测值（NPV）。
在单侧减弱（UW）的热刺激试验中（UW，>=25%），三 test 的敏感性为 63.6%，特异性为 85.4%，阳性预测值（PPV）为 71.4%，阴性预测值（NPV）为 80.4%。换句话说，80.4%的三 test 阴性患者也有正常的热刺激试验反应。在明显的管腔麻痹（UW，>=50%）中，三 test 的敏感性为 81.8%，特异性为 81.4%，PPV 为 55.1%，NPV 为 94.1%。具有不同经验水平的检查者评估的 2 个亚组之间存在显著差异（p < 0.05）。
三 test 是一种很好的筛选工具，可以快速可靠地排除单侧减弱，特别是热刺激试验中明显的管腔麻痹。
