Department of Otolaryngology-Head and Neck Surgery, Seoul Saint Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea.
Department of Otolaryngology-Head and Neck Surgery, Bucheon Saint Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea.
Otol Neurotol. 2022 Feb 1;43(2):146-152. doi: 10.1097/MAO.0000000000003430.
To compare the diagnostic accuracy of cervical vestibular-evoked myogenic potential (cVEMP) for detecting superior canal dehiscence (SCD) syndrome to that of computed tomography (CT) and surgical findings.
PubMed, SCOPUS, Embase, Web of Science, and the Cochrane database.
Databases were searched up to July 2021. True positives, true negatives, false positives, and false negatives were extracted. Methodological quality was assessed using the Quality Assessment of Diagnostic Accuracy Studies 2 tool.
Our search yielded nine studies with 721 patients. Including all cVEMP thresholds, the diagnostic odds ratio (DOR) was 32.8483 (95% confidence interval [CI]: 19.6577, 54.8900; I2 = 49.9%). The area under the summary receiver operating characteristic curve (AUC) was 0.879. Sensitivity and specificity were 0.8278 (95% CI: 0.7517, 0.8842; I2 = 76.4%) and 0.8824 (95% CI: 0.7859, 0.9387; I2 = 92.8%), respectively. However, there was a high degree of heterogeneity (I2 ≥ 70%) due to the different VEMP threshold values used among the studies. In subgroup analysis, higher cVEMP threshold values showed higher sensitivity (threshold ≤ 85: 0.9568; threshold ≤ 65: 0.7691) but lower specificity (threshold ≤ 85: 0.5879; threshold ≤ 65: 0.8913). The threshold ≤75 subgroup showed moderate sensitivity of 0.7455, high specificity of 0.9526, and the highest DOR of 38.9062. The AUC of this subgroup was 0.894.
cVEMP is a reliable adjunctive tool for the clinical diagnosis of SCD. Taking the balance between sensitivity and specificity into consideration, a cVEMP threshold value of 75 showed good diagnostic accuracy.
比较颈前庭诱发肌源性电位（cVEMP）诊断上半规管裂（SCD）综合征的准确性与计算机断层扫描（CT）和手术结果的诊断准确性。
PubMed、SCOPUS、Embase、Web of Science 和 Cochrane 数据库。
检索截至 2021 年 7 月的数据库。提取真阳性、真阴性、假阳性和假阴性。使用诊断准确性研究质量评估工具 2 评估方法学质量。
我们的搜索结果包括 9 项研究，共 721 名患者。包括所有 cVEMP 阈值在内，诊断比值比（DOR）为 32.8483（95%置信区间[CI]：19.6577，54.8900；I2=49.9%）。汇总受试者工作特征曲线下面积（AUC）为 0.879。灵敏度和特异度分别为 0.8278（95%CI：0.7517，0.8842；I2=76.4%）和 0.8824（95%CI：0.7859，0.9387；I2=92.8%）。然而，由于研究中使用的不同 VEMP 阈值值，存在高度异质性（I2≥70%）。在亚组分析中，较高的 cVEMP 阈值值显示出较高的灵敏度（阈值≤85：0.9568；阈值≤65：0.7691），但特异性较低（阈值≤85：0.5879；阈值≤65：0.8913）。阈值≤75 亚组的灵敏度为 0.7455，特异性为 0.9526，DOR 最高为 38.9062。该亚组的 AUC 为 0.894。
cVEMP 是 SCD 临床诊断的可靠辅助工具。考虑到灵敏度和特异性之间的平衡，cVEMP 阈值为 75 显示出良好的诊断准确性。
