Janky Kristen L, Patterson Jessie N, Shepard Neil T, Thomas Megan L A, Honaker Julie A
Boys Town National Research Hospital, Department of Audiology, Omaha, NE.
University of Nebraska-Lincoln, Department of Special Education and Communication Disorders, Lincoln, NE.
J Am Acad Audiol. 2017 Oct;28(9):778-785. doi: 10.3766/jaaa.16138.
Numerous video head impulse test (vHIT) devices are available commercially; however, gain is not calculated uniformly. An evaluation of these devices/algorithms in healthy controls and patients with vestibular loss is necessary for comparing and synthesizing work that utilizes different devices and gain calculations.
Using three commercially available vHIT devices/algorithms, the purpose of the present study was to compare: (1) horizontal canal vHIT gain among devices/algorithms in normal control subjects; (2) the effects of age on vHIT gain for each device/algorithm in normal control subjects; and (3) the clinical performance of horizontal canal vHIT gain between devices/algorithms for differentiating normal versus abnormal vestibular function.
Prospective.
Sixty-one normal control adult subjects (range 20-78) and eleven adults with unilateral or bilateral vestibular loss (range 32-79).
vHIT was administered using three different devices/algorithms, randomized in order, for each subject on the same day: (1) Impulse (Otometrics, Schaumberg, IL; monocular eye recording, right eye only; using area under the curve gain), (2) EyeSeeCam (Interacoustics, Denmark; monocular eye recording, left eye only; using instantaneous gain), and (3) VisualEyes (MicroMedical, Chatham, IL, binocular eye recording; using position gain).
There was a significant mean difference in vHIT gain among devices/algorithms for both the normal control and vestibular loss groups. vHIT gain was significantly larger in the ipsilateral direction of the eye used to measure gain; however, in spite of the significant mean differences in vHIT gain among devices/algorithms and the significant directional bias, classification of "normal" versus "abnormal" gain is consistent across all compared devices/algorithms, with the exception of instantaneous gain at 40 msec. There was not an effect of age on vHIT gain up to 78 years regardless of the device/algorithm.
These findings support that vHIT gain is significantly different between devices/algorithms, suggesting that care should be taken when making direct comparisons of absolute gain values between devices/algorithms.
市面上有许多视频头脉冲测试(vHIT)设备;然而,增益的计算方法并不统一。有必要对这些设备/算法在健康对照者和前庭功能丧失患者中进行评估,以便比较和综合使用不同设备及增益计算方法的研究成果。
本研究使用三种市售的vHIT设备/算法,旨在比较:(1)正常对照受试者中各设备/算法之间水平半规管vHIT增益;(2)年龄对正常对照受试者中各设备/算法vHIT增益的影响;(3)各设备/算法之间水平半规管vHIT增益在区分正常与异常前庭功能方面的临床性能。
前瞻性研究。
61名正常对照成年受试者(年龄范围20 - 78岁)和11名单侧或双侧前庭功能丧失的成年受试者(年龄范围32 - 79岁)。
在同一天,对每位受试者使用三种不同的设备/算法按随机顺序进行vHIT测试:(1)Impulse(奥听公司,美国伊利诺伊州绍姆堡;单眼记录,仅右眼;使用曲线下面积增益),(2)EyeSeeCam(丹麦国际听力公司;单眼记录,仅左眼;使用瞬时增益),以及(3)VisualEyes(美国伊利诺伊州查塔姆的MicroMedical公司;双眼记录;使用位置增益)。
正常对照和前庭功能丧失组中,各设备/算法之间的vHIT增益存在显著的平均差异。用于测量增益的眼睛同侧方向的vHIT增益显著更大;然而,尽管各设备/算法之间的vHIT增益存在显著的平均差异以及显著的方向偏差,但除40毫秒时的瞬时增益外,所有比较的设备/算法在“正常”与“异常”增益分类上是一致的。无论使用何种设备/算法,78岁之前年龄对vHIT增益均无影响。
这些发现表明各设备/算法之间的vHIT增益存在显著差异,这表明在对不同设备/算法的绝对增益值进行直接比较时应谨慎。