METAANALYSIS OF THE SENSITIVITY AND SPECIFICITY OF PLATFORM POSTUROGRAPHY

Objective: To compare the sensitivity and specificity of platform post urography with other vestibular tests for patients with peripheral ves tibular deficits (PVD), Meniere's disease, benign paroxysmal positiona l vertigo (BPPV), and central nervous system-vestibular impairment (CN S). Data Sources: A computed search was conducted using the Index Medi cus database (1966-1994) and Current Contents Science Editions. Study Selection: Studies were selected for analysis if the article addressed the sensitivity and/or specificity of platform posturography, compare d posturography with another objective test of vestibular function, id entified the basis for abnormal test results, and reported the data wi th sufficient detail to calculate an effect size from a 2X2 contingenc y table. Data Extraction: A count of the normal and abnormal test resu lts for posturography and the criterion standard were retrieved from e ach article, analyzed using a chi(2) statistic, and converted to an ef fect size. A positive effect size indicated that posturography identif ied abnormalities in patients who had normal tests on the criterion st andard. Data Synthesis: Sensitivity and specificity of posturography w ere 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, compare d with 41% for PVD, and 44% for mixed CNS and PVD (F-2,F-12=5.26, P=.0 2) 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 (F-2,F-12=13.95, P=.001). Conclusions: Platform posturography provides a measurable supplement to the standard vestibular examination. The e nhancement was most notable when the target population included patien ts with CNS deficits.