未经证实:良性阵发性位置性眩晕(BPPV)是最常见的前庭疾病。已经报道了机械旋转椅(MRC)用于BPPV管理的治疗和诊断益处。以前没有研究将MRC的诊断与检查床上的传统诊断进行比较。
UNASSIGNED:调查使用MRC进行的BPPV诊断与在检查床上进行的传统诊断之间的一致性。次要目标是(1)检查两种测试模式在诊断时,与从私人ENT(复杂BPPV)转诊的患者相比,从全科医生(无复杂BPPV)转诊的大部分未经治疗的患者的诊断特性是否不同,以及(2)检查在手动诊断(MD)期间受损的参与者合作是否改变了协议,敏感性和特异性。
UNASSIGNED:前瞻性随机临床试验,通过全科医生的转诊招募有BPPV病史的患者,耳鼻喉科医生和丹麦北部地区的其他医院部门。参与者接受了两次诊断检查:一次是在检查床上的传统MD,一次是MRC。初始检查者和测试方式的顺序是随机的。审查员对彼此的发现视而不见。
UNASSIGNED:在测试诊断BPPV的能力时,两种测试模式之间的协议,是0.83,科恩的卡帕0.66。将MD诊断与MRC诊断进行比较时(在测试结果解释后设置为黄金标准诊断),MD的值为:灵敏度71%,特异性98%,负预测值73%,和正预测值97%。关于BPPV亚型分类的一致性为0.71,科恩的kappa为0.58。分离诊断为后泪管结石症(p-CAN)时的一致性为0.89,科恩的kappa为0.78。
未经评估:诊断,在MRC的帮助下,比传统的手动BPPV诊断更敏感。测试模式之间的总体协议水平被发现是弱到中等。将诊断程序隔离到p-CAN时,协议水平增加到“中等-强”。“结果还显示,在没有或单一治疗尝试后直接从全科医生那里检查患者时,测试模式之间的一致性更高,MD的阴性预测值明显更高。在合作程度较高的患者中,MD的诊断特性得到了改善。
UNASSIGNED: Benign paroxysmal positional vertigo (BPPV) is the most common vestibular disease. Both therapeutic and diagnostic benefits with mechanical rotation chairs (MRCs) for management of BPPV have been reported. No previous studies have compared diagnostics in MRCs to traditional diagnostics on an examination bed.
UNASSIGNED: To investigate the agreement between BPPV diagnostics performed with an MRC and traditional diagnostics on an examination bed. Secondary objectives were to (1) examine if the two test modalities differ in diagnostic properties when diagnosing largely untreated patients referred from general practitioners (uncomplicated BPPV) compared to patients referred from private ENTs (complicated BPPV) and (2) examine whether impaired participant cooperation during Manual Diagnostics (MDs) alters agreement, sensitivity and specificity.
UNASSIGNED: Prospective randomized clinical trial in which patients with a case history of BPPV were recruited by referrals from general practitioners, otorhinolaryngologists and other hospital departments in the Northern Region of Denmark. Participants underwent diagnostic examinations twice: once by traditional MDs on an examination bed and once with an MRC. Initial examiner and order of test modality were randomized. Examiners were blinded to each other\'s findings.
UNASSIGNED: When testing the ability to diagnose BPPV, agreement between the two test modalities, was 0.83, Cohen\'s kappa 0.66. When comparing MD diagnostics to MRC diagnostics (set as gold standard diagnostics following test result interpretation), values for MDs were: sensitivity 71%, specificity 98%, Negative Predictive Value 73%, and Positive Predictive Value 97%. Agreement regarding BPPV subtype classification was found to be 0.71, and Cohen\'s kappa 0.58. Agreement when isolating the diagnosis to posterior canalolithiasis (p-CAN) was 0.89, Cohen\'s kappa 0.78.
UNASSIGNED: Diagnostics, aided by an MRC, are more sensitive than traditional manual BPPV diagnostics. The overall agreement level between test modalities was found to be weak to moderate. When isolating diagnostics to p-CAN, the level of agreement increased to \"moderate-strong.\" Results also showed higher agreement between test modalities and a significantly higher negative predictive value for MDs when examining patients referred directly from General Practitioners following no- or a single treatment attempt. The diagnostic properties of MDs improved in patients with a higher degree of cooperation.