Meta-analysis of the sensitivity and specificity of platform posturography.
OBJECTIVE
To compare the sensitivity and specificity of platform posturography with other vestibular tests for patients with peripheral vestibular deficits (PVD), Meniere's disease, benign paroxysmal positional vertigo (BPPV), and central nervous system-vestibular impairment (CNS).


METHODS
A computed search was conducted using the Index Medicus database (1966-1994) and Current Contents Science Editions.


METHODS
Studies were selected for analysis if the article addressed the sensitivity and/or specificity of platform posturography, compared posturography with another objective test of vestibular function, identified the basis for abnormal test results, and reported the data with sufficient detail to calculate an effect size from a 2 x 2 contingency table.


METHODS
A count of the normal and abnormal test results for posturography and the criterion standard were retrieved from each article, analyzed using a chi 2 statistic, and converted to an effect size. A positive effect size indicated that posturography identified abnormalities in patients who had normal tests on the criterion standard.


RESULTS
Sensitivity and specificity of posturography were about 50%. The overall effect size was small (0.13) but positive. The diagnostic category had a significant influence on the predictive value of abnormal results (73% for Meniere's disease and BPPV, compared with 41% for PVD, and 44% for mixed CNS and PVD (F2,12 = 5.26, P = .02) and on the magnitude of the effect size (0.41 for mixed CNS and PVD compared with 0.22 for Meniere's disease and BPPV, and -0.10 for PVD (F2,12 = 13.95, P = .001).


CONCLUSIONS
Platform posturography provides a measurable supplement to the standard vestibular examination. The enhancement was most notable when the target population included patients with CNS deficits.
Di Fabio
R P
RP
Department of Physical Medicine and Rehabilitation, University of Minnesota, Minneapolis, USA.
D000043:Abstracting and Indexing; D000704:Analysis of Variance; D015987:Effect Modifier, Epidemiologic; D006801:Humans; D004856:Postural Balance; D011187:Posture; D015203:Reproducibility of Results; D012107:Research Design; D012680:Sensitivity and Specificity; D015837:Vestibular Diseases / Q000175:diagnosis* / Q000503:physiopathology; D014724:Vestibular Function Tests / Q000379:methods* / Q000592:standards*