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The aim is to investigate the accuracy of manual diagnostics of benign paroxysmal positional vertigo (BPPV) by comparing it to BPPV diagnostics in mechanical rotational chair (TRV chair). VNG (videonystagmography) goggles will be used in both scenarios.
Furthermore, the investigators will examine the importance of angulation and velocity in relation to the diagnostic outcome.
Open-label, randomized controlled trial with cross over comparing manual bedside BPPV diagnostics with diagnostics in a mechanical rotational chair (TRV chair) when using VNG goggles in both scenarios.
Patients with a history of positional vertigo will be considered for enrollment and randomized to which diagnostic modality they begin with. Each subject will wait for minimum 30 minutes between the two diagnostics.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Bedside BPPV diagnostics | Active Comparator | Diagnostics of BPPV with manual tests using VNG goggles. The goggles will be added an IMU sensor detecting angulation and velocity (the physician will not get feedback from the sensor during the examination. This will only be used in later analysis). |
|
| TRV BPPV diagnostics | Active Comparator | Diagnostics of BPPV using the TRV chair. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| BPPV diagnostic | Diagnostic Test | Supine Roll Test and Dix-Hallpike Test |
|
| Measure | Description | Time Frame |
|---|---|---|
| Diagnostic Accuracy | Sensitivity, specificity, positive predictive value and negative predictive value of bedside examination (index-test). Gold standard is diagnostics in the TRV chair. | 2 year |
| Measure | Description | Time Frame |
|---|---|---|
| Head angulation during diagnostic bedside examination. | Angulation of the head during diagnostic bedside examination will be measured using an IMU sensor. Data will be presented as the difference in head angulation compared to the ideal angulation descriped for the diagnostic tests. | 2 year |
| Angular velocity during diagnostic bedside examination |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Malene Hentze Hansen, MD | Department of Otolaryngology, Head & Neck Surgery and Audiology | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Department of Otolaryngology, Head & Neck Surgery and Audiology, Aalborg University Hospital | Aalborg | North Denmark | 9000 | Denmark |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 41111959 | Derived | Hentze M, Hougaard DD, Kingma H. Impact of head orientation and head movement in traditional manual diagnostics of benign paroxysmal positional vertigo: a randomized controlled crossover study. Front Neurol. 2025 Oct 3;16:1654404. doi: 10.3389/fneur.2025.1654404. eCollection 2025. | |
| 39860440 | Derived | Hentze M, Hougaard DD, Kingma H. The Intra-Examiner Variability in and Accuracy of Traditional Manual Diagnostics of Benign Paroxysmal Positional Vertigo: A Prospective Observational Cohort Study. J Clin Med. 2025 Jan 11;14(2):434. doi: 10.3390/jcm14020434. |
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| ID | Term |
|---|---|
| D065635 | Benign Paroxysmal Positional Vertigo |
| D014717 | Vertigo |
| D015837 | Vestibular Diseases |
| D007759 | Labyrinth Diseases |
| ID | Term |
|---|---|
| D004427 | Ear Diseases |
| D010038 | Otorhinolaryngologic Diseases |
| D009461 | Neurologic Manifestations |
| D009422 | Nervous System Diseases |
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| TRV chair | Device | Mechanical rotational chair |
|
| VNG goggles | Device | Goggles for video nystagmography |
|
| IMU sensor | Device | A sensor that measures triaxial acceleration and triaxial angular velocity. |
|
| Manual BPPV diagnostics | Procedure | Bedside BPPV diagnostics |
|
Angular velocity of the head movements during diagnostic bedside examination will be measured using an IMU sensor. Data will be presented as mean velocity and peak velocity. |
| 2 year |
| 39711790 | Derived | Hentze M, Hougaard DD, Kingma H. Is diagnostics of Benign Paroxysmal Positional Vertigo with a mechanical rotation chair superior to traditional manual diagnostics? A randomized controlled crossover study. Front Neurol. 2024 Dec 6;15:1519837. doi: 10.3389/fneur.2024.1519837. eCollection 2024. |
| D012816 | Signs and Symptoms |
| D013568 | Pathological Conditions, Signs and Symptoms |