Diagnostic accuracy of side-lying test for diagnosis Benign Paroxysmal Positional Vertigo (BPPV)

Abstract

Objective: To determine sensitivity, specificity, likelihood ratio of side-lying test for diagnosis Benign paroxysmal positional vertigo when compare to Six-Hallpike test Design: A diagnostic cross-sectional study Setting: Dizziness and hearing clinic, Department of Otolaryngology, Faculty of Medicine, Chulalongkorn University Method: Eighty-six dizzy patients, who experience vertigo not more than one month were assessed for having bening paroxysmal positional vertigo (BPPV). Both Dix-Hallpike maneuver and side-lying test were done under the computerized video electronystagmography. The diagnostic performance of side-lying test was analyzed using Dix-Hallpike test as the gold standard. During the procedure, the examiner recorded for the adverse events. Result: There were 86 patients (60 females, 26 males) enrolled into the study with age range from 10 to 79 (mean 54.1 yrs) years. The prevalence of BPPV in this study was 49 (57%). Sensitivity was 89.8%(81.3-98.6), specificity was 89.2% (79.2-99.2), accuracy was 85.5%, positive predictive value, negative predictive value and likelihood ratio were 91.7%, 86.8% and 8.3 accordingly. There was no significant difference in adverse events. Subgroup analysis shows more prevalence rate in higher age. The sensitivity is also higher in older group, in contrast to specificity which was extremely high in younger age group. Conclusion: Side-lying test had relatively high diagnostic performance for diagnosis benign paroxysmal positional vertigo when us Dix-Hallpike maneuver as a gold standard. Side-lying test may be an alternative for diagnosis BPPV.