ArticleFrontiers in neurology
Validation of a portable video head impulse test using an iPod touch and an oral stabilization three-dimensional (3D) - printed mount: a method-comparison study.
Article in Frontiers in neurology. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Although video head impulse testing (vHIT) is widely used to assess semicircular canal function, access to quantitative vestibular testing remains limited. Smartphone-based vHIT systems with goggle-based fixation have been described, but larger validation studies and improved fixation stability are needed. We evaluated a portable vHIT application using an iPod touch with an oral stabilization three-dimensional (3D)-printed mount to determine whether it detects laterality in unilateral vestibular hypofunction and is noninferior to a medical-grade device for a patient-level laterality endpoint. Methods: Thirteen patients with unilateral vestibular hypofunction and 14 healthy volunteers underwent testing with the portable and medical-grade vHIT systems on the same day. The primary endpoint was the patient-level laterality difference, defined as the difference between unaffected and affected vestibulo-ocular reflex (VOR) gain. Noninferiority was assessed using the two-sided 95% confidence interval (CI) for the mean between-device difference with a prespecified margin of 0.15. Agreement was evaluated using Bland-Altman analysis. Secondarily, absolute VOR gain agreement between devices was evaluated. False-positive classifications in healthy volunteers were assessed at the ear and subject levels using a gain threshold of <0.78. Results: Both systems showed higher VOR gains on the unaffected side (paired Conclusion: The portable vHIT system detected laterality in unilateral vestibular hypofunction and met noninferiority criteria relative to a medical-grade device. Larger studies are warranted to refine quality control and define individual-ear absolute VOR gain agreement.
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