Rp. Difabio, METAANALYSIS OF THE SENSITIVITY AND SPECIFICITY OF PLATFORM POSTUROGRAPHY, Archives of otolaryngology, head & neck surgery, 122(2), 1996, pp. 150-156
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.