[To analyze the screening value of vestibular monothermal caloric tests].
OBJECTIVE
To investigate the screening value and the reliability of the monothermal caloric tests (MCT) in evaluating vestibular function.


METHODS
One thousand and four hundred and six vertigo patients were divided into two groups. Seven hundred and five cases were stimulated by different temperature air from cold to warm. The caloric test sequence of other 701 cases was opposite. The first stimulated cold or warm air test was regarded as monothermal cold caloric test (MCCT) or monothermal warm caloric test (MWCT). The unilateral weakness (UW) and directional preponderance (DP) of the bithermal caloric tests (BCT) and the UW of the MCT were calculated. By defining the BCT results as the standard, the sensitivity, specificity, Youden's index and kappa were calculated.


RESULTS
Four hundred and twenty-eight showed abnormal BCT and MCCT. One hundred and forty-five showed normal BCT and MCCT. 85, 47 showed isolated abnormal BCT and abnormal MCCT respectively. The sensitivity of the MCCT was 83.4%, specificity was 75.5%, Youden's index was 0.589 and kappa was 0.555 (P<0.01). Four hundred and twenty-nine showed abnormal BCT and MWCT, 130 showed normal BCT and MWCT. 82, 60 showed isolated abnormal BCT and abnormal MWCT respectively. The sensitivity of the MWCT was 84.0%, specificity was 68.4%, Youden's index was 0.524 and kappa was 0.505 ( P<0.01). The sensitivity of the MCCT and MWCT were 86.9% and 86.9% respectively when cases accompanied by spontaneous nystagmus (SN) were excluded. The sensitivity of the MCCT and MWCT were 89.3% and 88.1% respectively when cases with abnormal DP were excluded.


CONCLUSIONS
The high false-positive and false-negative rate of the MCT limit the usefulness as a screening test due to the influence of DP and SN.
First Center Clinical College of Tianjin Medical University, Tianjin, 300070, China.
Shiping
S
Sun
Peng
P
Lin
Taisheng
T
Chen
Wei
W
Song
Na
N
Wang
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002150:Caloric Tests / Q000379:methods*; D002648:Child; D002675:Child, Preschool; D005188:False Negative Reactions; D005189:False Positive Reactions; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012680:Sensitivity and Specificity; D014717:Vertigo / Q000175:diagnosis*; D015837:Vestibular Diseases / Q000175:diagnosis; D055815:Young Adult