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Monothermal caloric screening test performance: a relative operating characteristic curve analysis.
Ear Hear. 2009 Jun; 30(3):313-9.EH

Abstract

OBJECTIVE

The objective of the present study was to evaluate the performance of the monothermal caloric screening test in a large sample of patients.

DESIGN

A retrospective analysis of the medical records of 1002 consecutive patients who had undergone vestibular assessment at the Mayo Clinic during the years 1989 and 1990 was conducted. Patients with incomplete alternate binaural bithermal (ABB) caloric testing, congenital or periodic alternating nystagmus, or bilateral vestibular loss were excluded from the study. Clinical decision theory analyses (relative operating characteristic curves) were used to determine the accuracy with which the monothermal warm (MWST) and monothermal cool (MCST) caloric screening tests predicted the results of the ABB caloric test. Cumulative distributions were constructed as a function of the cutoff points for monothermal interear difference (IED) to select the cutoff point associated with any combination of true-positive and false-positive rates.

RESULTS

Both MWST and MCST performed well above chance level. The test performance for the MWST was significantly better than that of the MCST for three of the four ABB gold standards. A 10% IED cutoff point for the MWST yielded a false-negative rate of either 1% (UW >or=25%) or 3% (UW >or=20%). The use of a 10% IED (UW >or=25%) for the MWST would have resulted in a 40% reduction (N = 294) in the number of ABB caloric tests performed on patients without a unilateral weakness.

CONCLUSIONS

The results of this study indicated that the MWST decreases test time without sacrificing the sensitivity of the ABB caloric test.

Authors+Show Affiliations

Vestibular Research Laboratory, James H. Quillen VA Medical Center, Mountain Home, Tennessee 37684, USA. owen.murnane@med.va.govNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, U.S. Gov't, Non-P.H.S.
Validation Study

Language

eng

PubMed ID

19322091

Citation

Murnane, Owen D., et al. "Monothermal Caloric Screening Test Performance: a Relative Operating Characteristic Curve Analysis." Ear and Hearing, vol. 30, no. 3, 2009, pp. 313-9.
Murnane OD, Akin FW, Lynn SG, et al. Monothermal caloric screening test performance: a relative operating characteristic curve analysis. Ear Hear. 2009;30(3):313-9.
Murnane, O. D., Akin, F. W., Lynn, S. G., & Cyr, D. G. (2009). Monothermal caloric screening test performance: a relative operating characteristic curve analysis. Ear and Hearing, 30(3), 313-9. https://doi.org/10.1097/AUD.0b013e31819c3ec7
Murnane OD, et al. Monothermal Caloric Screening Test Performance: a Relative Operating Characteristic Curve Analysis. Ear Hear. 2009;30(3):313-9. PubMed PMID: 19322091.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Monothermal caloric screening test performance: a relative operating characteristic curve analysis. AU - Murnane,Owen D, AU - Akin,Faith W, AU - Lynn,Susan G, AU - Cyr,David G, PY - 2009/3/27/entrez PY - 2009/3/27/pubmed PY - 2009/10/30/medline SP - 313 EP - 9 JF - Ear and hearing JO - Ear Hear VL - 30 IS - 3 N2 - OBJECTIVE: The objective of the present study was to evaluate the performance of the monothermal caloric screening test in a large sample of patients. DESIGN: A retrospective analysis of the medical records of 1002 consecutive patients who had undergone vestibular assessment at the Mayo Clinic during the years 1989 and 1990 was conducted. Patients with incomplete alternate binaural bithermal (ABB) caloric testing, congenital or periodic alternating nystagmus, or bilateral vestibular loss were excluded from the study. Clinical decision theory analyses (relative operating characteristic curves) were used to determine the accuracy with which the monothermal warm (MWST) and monothermal cool (MCST) caloric screening tests predicted the results of the ABB caloric test. Cumulative distributions were constructed as a function of the cutoff points for monothermal interear difference (IED) to select the cutoff point associated with any combination of true-positive and false-positive rates. RESULTS: Both MWST and MCST performed well above chance level. The test performance for the MWST was significantly better than that of the MCST for three of the four ABB gold standards. A 10% IED cutoff point for the MWST yielded a false-negative rate of either 1% (UW >or=25%) or 3% (UW >or=20%). The use of a 10% IED (UW >or=25%) for the MWST would have resulted in a 40% reduction (N = 294) in the number of ABB caloric tests performed on patients without a unilateral weakness. CONCLUSIONS: The results of this study indicated that the MWST decreases test time without sacrificing the sensitivity of the ABB caloric test. SN - 1538-4667 UR - https://www.unboundmedicine.com/medline/citation/19322091/Monothermal_caloric_screening_test_performance:_a_relative_operating_characteristic_curve_analysis_ L2 - https://doi.org/10.1097/AUD.0b013e31819c3ec7 DB - PRIME DP - Unbound Medicine ER -