Otolaryngology Department, Dijon University Hospital, Dijon, France.
ImVia, Laboratory of Imagery and Artificial Vision, EA 7535, Burgundy University, Dijon, France.
Sci Rep. 2023 Feb 15;13(1):2718. doi: 10.1038/s41598-023-29801-8.
In this study, a training simulator for the examination of dizzy patients based on a virtual-reality-enhanced mannequin (VREM) was developed to evaluate the detection of catch-up saccades during head impulse test (HIT) and the effect of training in VREM. For novices (n = 35), 2 trials were conducted before and after a training session. Experts (n = 7) were submitted to an evaluation session. In each trial, a left or a right horizontal canal deficit with an overt catch-up saccade (delay between 110 and 320 ms) was randomly presented. Participants scored the difficulty in performing the maneuver, in recognizing the saccades, and the self-confidence in the diagnosis using a visual analogue scale (VAS). Saccade delay significantly influenced the performance. Training significantly improved the sensitivity in the residents (69.1% before to 97.9% after the training, p < 0.001, Fisher's exact test, n = 560 tests), surpassing experts' performances (p < 0.001, versus 87% in experts, Fisher's exact test). The specificity also increased to the expert level (78% before to 95% after the training, and 95% in experts, p < 0.001, Fisher's exact test). The VAS showed a decrease difficulty to execute the HIT, with an increase in the confidence after training. VREM improved the HIT execution performance and the confidence in novice practitioners.
在这项研究中，开发了一种基于虚拟现实增强模型（VREM）的眩晕患者检查训练模拟器，用于评估在头脉冲测试（HIT）中检测追赶性眼跳的能力，以及在 VREM 中进行训练的效果。对于新手（n=35），在训练前后进行了 2 次测试。专家（n=7）接受了评估测试。在每个测试中，都会随机呈现一个左或右侧水平半规管缺陷，伴有明显的追赶性眼跳（延迟 110-320 毫秒）。参与者使用视觉模拟量表（VAS）对执行操作的难度、识别眼跳的难度以及对诊断的信心进行评分。眼跳延迟明显影响了测试结果。培训显著提高了新手的敏感性（培训前为 69.1%，培训后为 97.9%，p<0.001，Fisher 确切检验，n=560 次测试），超过了专家的表现（p<0.001，专家的敏感性为 87%，Fisher 确切检验）。特异性也提高到了专家水平（培训前为 78%，培训后为 95%，专家为 95%，p<0.001，Fisher 确切检验）。VAS 显示执行 HIT 的难度降低，培训后信心增加。VREM 提高了新手从业者执行 HIT 的表现和信心。
