Meta-Analysis of the Use of Head Impulse Test and Head Impulse Test with Direction Changing Nystagmus and Test of Skew Deviation in the Diagnosis of Peripheral Vertigo and Stroke
Cerebrovascular Diseases
Ooi, S., Phillips, G., et al. (2023).
Cerebrovascular Diseases, 52(2), 184-193.
This systematic review and meta-analysis investigates the accuracy of the Head Impulse Test (HIT) and the Head Impulse Test with Direction Changing Nystagmus (HINTS) to diagnose peripheral vertigo and stroke-associated central vertigo.
None declared
From database inception to July 2021
Cohort and cross-sectional trials with either retrospective or prospective designs
11
The following findings were reported regarding the accuracy of utilizing the HIT and HINTS in diagnosing peripheral vertigo and stroke-associated central vertigo:<br />
<ul>
<li><strong>HIT and central vertigo:</strong> A positive likelihood ratio (PLR) of 5.85 and negative likelihood ratio (NLR) of 0.17 were reported. The area under the ROC curve (AUC) was found to be 0.92.</li>
<li><strong>HIT and peripheral vertigo:</strong> A PLR of 4.85 and NLR of 0.19 were reported. The AUC was found to be 0.90.</li>
<li><strong>HINTS and central vertigo:</strong> A PLR of 5.61 and NLR of 0.06 were reported.</li>
<li><strong>HINTS and peripheral vertigo:</strong> A PLR of 17.3 and NLR of 0.15 were reported. </li>
</ul>
Overall, these findings suggest that the HIT and HINTS "appear to be moderately good discriminators of central and peripheral vertigo" (p. 184). However, these results should be interpreted with caution due to significant heterogeneity between included studies and the general lateness (i.e., >24 hours) of the provision of testing within these studies.
