Affiliations: [a] Department of Otolaryngology, Puerta del Mar University Hospital, Cádiz, Spain
| [b] Biomedical Research and Innovation Institute of Cádiz (INiBICA), Cádiz, Spain
| [c] Department of Child and Mother Health and Radiology, Medical School, University of Cádiz, Cádiz, Spain
Correspondence:
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Corresponding author: Antonio Martin-Mateos Departamento ORL. Hospital U. Puerta del Mar. Av. Ana de Viya 21, CP: 11009, Cádiz, Spain. Tel.: +34 651568420; E-mail: antonioj.martin.sspa@juntadeandalucia.es.
Abstract: BACKGROUND:The subjective visual vertical (SVV) test is a sensitive test of vestibular dysfunction that allows the evaluation of otolithic organs; however, with the current method, there are technical and logistical limitations that make the application of this test difficult in the conventional clinic. OBJECTIVE:The objective of this study is to assess the effectiveness of detecting vestibular pathology using the SVV via a new screening method. METHODS:A consecutive sample of 62 patients with suspected vestibular pathology was included in the study. The patients were clinically diagnosed according to the Barany Society criteria. An exploratory system was designed using a mobile application in Android that detects accelerometer oscillations and involves placing the smartphone on a rotating disk anchored to the wall. All patients underwent a SVV examination using the bucket method and the study test. A cut-off point of the ROC curve was calculated for each test, and its sensitivity, specificity, diagnostic accuracy and probability ratios for detecting vestibular pathology were analysed. The SVV results were compared using the bucket test and the study test. RESULTS:We observed significant differences in sensitivity between the two tests: 86.95% for the study test versus 67.4% for the bucket test (p < 0.01). In the ROC curve, an area under the curve of 0.90 was observed for the study test, with a cut-off of 2.43 for a sensitivity of 86.95% and a specificity of 93.75%. CONCLUSIONS:SVV testing using a smartphone placed on a rotating disk anchored to the wall offers greater diagnostic accuracy than SVV using the bucket test. Both methods are inexpensive, harmless and easily accepted by patients.
