Sensitivity and specificity of the modified tandem walking test for vestibular hypofunction with chronic dizziness in young adults

BACKGROUND: Obstructive sleep apnea (OSA) has been linked to vestibular dysfunction, but no prior studies have investigated the relationship between Persistent Postural Perceptual Dizziness (PPPD), a common cause of chronic dizziness, and OSA. OBJECTIVE AND METHODS: We determined the frequency of OSA in an uncontrolled group of PPPD patients from a tertiary dizziness clinic based on polysomnogram (PSG). We then assessed the sensitivity and specificity of common OSA questionnaires in this population. RESULTS: Twenty-five patients with PPPD underwent PSG (mean age 47, 60% female, mean BMI 29.5). A majority, or 56%, of patients were diagnosed with OSA, and in most, the OSA was severe. OSA patients were older (56 years versus 40 years, p = 0.0006) and had higher BMI (32 versus 26, p = 0.0078), but there was no clear gender bias (56% versus 64% female, p = 1.00). The mean sensitivity and specificity of the STOP BANG questionnaire for detecting OSA was 86% and 55%, respectively. Sensitivity and specificity of the Berlin Questionnaire was 79% and 45%, respectively. CONCLUSIONS: The prevalence of OSA was much higher in our small PPPD group than in the general population. Screening questionnaires appear to demonstrate good sensitivity to detect PPPD patients at risk of OSA in this small study. Future studies should confirm these findings and determine whether treatment of OSA improves symptoms in PPPD.

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Validation of the short Mood and Feelings Questionnaire in young adulthood

10.1101/2021.01.22.21250311 ◽

2021 ◽

Author(s):

Olga Eyre ◽

Rhys Bevan Jones ◽

Sharifah Shameem Agha ◽

Robyn E Wootton ◽

Ajay K Thapar ◽

...

Keyword(s):

Young Adults ◽

Sensitivity And Specificity ◽

Young Adulthood ◽

Early Adulthood ◽

Well Being ◽

The Self ◽

Depression Symptoms ◽

Cut Points ◽

Cut Point ◽

Dsm 5

AbstractBackgroundDepression often onsets in adolescence and is associated with recurrence in adulthood. There is a need to identify and monitor depression symptoms across adolescence and into young adulthood. The short Mood and Feelings Questionnaire (sMFQ) is commonly used to measure depression symptoms in adolescence but has yet to be validated in young adulthood. This study aimed to (1) examine whether the sMFQ is a valid assessment of depression in young adults, and (2) identify cut-points that best capture a DSM-5 diagnosis of depression at age 25.MethodsThe sample included young people who took part in the Avon Longitudinal Study of Parents and Children (ALSPAC) at age 25 (n=4098). Receiver Operating Characteristic analyses were used to examine how well the self-rated sMFQ discriminates between cases and non-cases of DSM-5 Major Depressive Disorder (MDD) classified using the self-rated Development and Well Being Assessment. Sensitivity and specificity values were used to identify cut-points on the sMFQ.ResultsThe sMFQ had high accuracy for discriminating MDD cases from non-cases at age 25. The commonly used cut-point in adolescence (≥12) performed well at this age, best balancing sensitivity and specificity. However, a lower cut-point (≥10) may be appropriate in some contexts, e.g. for screening, when sensitivity is favoured over specificity.LimitationsALSPAC is a longitudinal population cohort that suffers from non-random attrition.ConclusionsThe sMFQ is a valid measure of depression in young adults in the general population. It can be used to screen for and monitor depression across adolescence and early adulthood.

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Diagnostic sensitivity and specificity of 2-mSv CT vs. conventional-dose CT in adolescents and young adults with suspected appendicitis: post hoc subgroup analysis of the LOCAT data

European Radiology ◽

10.1007/s00330-020-06811-y ◽

2020 ◽

Vol 30 (8) ◽

pp. 4573-4585

Author(s):

Yousun Ko ◽

◽

Woo Joo Lee ◽

Ji Hoon Park ◽

Hae Young Kim ◽

...

Keyword(s):

Young Adults ◽

Sensitivity And Specificity ◽

Subgroup Analysis ◽

Diagnostic Sensitivity ◽

Adolescents And Young Adults ◽

Suspected Appendicitis ◽

Conventional Dose ◽

Diagnostic Sensitivity And Specificity ◽

Post Hoc

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Optimizing the Sensitivity of the Head Thrust Test for Identifying Vestibular Hypofunction

Physical Therapy ◽

10.1093/ptj/84.2.151 ◽

2004 ◽

Vol 84 (2) ◽

pp. 151-158 ◽

Cited By ~ 67

Author(s):

Michael C Schubert ◽

Ronald J Tusa ◽

Lawrence E Grine ◽

Susan J Herdman

Keyword(s):

Health Information ◽

Sensitivity And Specificity ◽

Semicircular Canal ◽

Medical Records ◽

Semicircular Canals ◽

Test Results ◽

Lateral Semicircular Canal ◽

Ocular Reflex ◽

Vestibular Hypofunction ◽

Vestibulo Ocular Reflex

Abstract Background and Purpose. The head thrust test (HTT) is used to assess the vestibulo-ocular reflex. Sensitivity and specificity for diagnosing unilateral vestibular hypofunction (UVH) in patients following vestibular ablation is excellent (100%), although sensitivity is lower (35%–39%) for patients with nonsurgically induced UVH. The variability of the test results may be from moving the subject's head outside the plane of the lateral semicircular canals as well as using a head thrust of predictable timing and direction. The purpose of this study was to examine sensitivity and specificity of the horizontal HTT in identifying patients with UVH and bilateral vestibular hypofunction (BVH) when the head was flexed 30 degrees in attempt to induce acceleration primarily in the lateral semicircular canal and the head was moved unpredictably. Subjects. The medical records of 176 people with and without vestibular dysfunction (n=79 with UVH, n=32 with BVH, and n=65 with nonvestibular dizziness) were studied. Methods. Data were retrospectively tabulated from a de-identified database (ie, with health information stripped of all identifiers). Results. Sensitivity of the HTT for identifying vestibular hypofunction was 71% for UVH and 84% for BVH. Specificity was 82%. Discussion and Conclusion. Ensuring the head is pitched 30 degrees down and thrust with an unpredictable timing and direction appears to improve sensitivity of the HTT.

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Integrated Treatment Programme for Young Adults with Concurrent Disorders

European Psychiatry ◽

10.1016/s0924-9338(09)70637-6 ◽

2009 ◽

Vol 24 (S1) ◽

pp. 1-1

Author(s):

A. Amaladoss ◽

K. MacCullam ◽

B. MacPherson

Keyword(s):

Mental Illness ◽

Young Adults ◽

Outcome Measures ◽

Sensitivity And Specificity ◽

Treatment Program ◽

Early Stage ◽

Pilot Project ◽

Integrated Treatment ◽

Small Sample ◽

Concurrent Disorders

Background:The incidence of substance use, abuse and dependence seem to be increasing (1). It is probable that underlying mental illness, may reinforce individual's continuing substance indulgence (2), and If not intervened early, the consequence of this not only affects individual health, but also poses the threat of them procreating future sufferers.Objective:To detect mental illness at an early stage, in young adults with drug indulging behavior, and early intervention could be attempted.Method:A pilot project has been undertaken, for young adults (16-20 years) with concurrent disorder providing integrated intensive treatment program for six months. 12 patients were enrolled the study and 8 patients completed the study. A questionnaire has been devised to detect the probable existence of concurrent disorders. Assessment in all tridimensional spheres and intervened concurrently by the multidisciplinary team members. The outcome measures with the patients and the personnel were assessed by an independent assessor. The sensitivity and specificity of the devised questionnaire, has been measured.Result:There is significant correlation between underlying mental illness with drug indulgence and specific drug preference with type of mental illness have been elicited. The outcome measures along with the sensitivity and specificity of the questionnaire have been found significantly positive.Conclusion:It seems that the integrated treatment program is quite effective although resource consuming.Limitation:Small sample and limited duration which needs further replication.

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Gait Speed in Relation to Categories of Functional Ambulation After Spinal Cord Injury

Neurorehabilitation and Neural Repair ◽

10.1177/1545968308324224 ◽

2008 ◽

Vol 23 (4) ◽

pp. 343-350 ◽

Cited By ~ 64

Author(s):

Hubertus J. A. van Hedel

Keyword(s):

Spinal Cord ◽

Spinal Cord Injury ◽

Sensitivity And Specificity ◽

Walking Speed ◽

High Sensitivity ◽

Walking Test ◽

Human Spinal Cord ◽

Receiver Operating Characteristic Curves ◽

Cord Injury ◽

European Multicenter Study

Objective. The aim of the present study was to assess gait speeds that distinguished between levels of functional ambulation in subjects with a spinal cord injury. Methods. The data of 886 spinal cord injury subjects were derived from the European Multicenter Study for Human Spinal Cord Injury and analyzed at 1, 3, 6, and 12 months after injury. The indoor and outdoor mobility items from the Spinal Cord Independence Measure were combined into 5 clinically relevant categories: (1) wheelchair-dependent, (2) supervised walker with outdoor wheelchair dependency, (3) indoor walker with outdoor wheelchair dependency, (4) walker with aid, and (5) walker without aid. The preferred walking speed that distinguished between ambulation categories was derived from the 10-meter walking test and determined using receiver operating characteristic curves. Results. The walking speed correlated well (>0.84) with the ambulation categories. The average walking speed for each category was (1) 0.01 m/s, (2) 0.34 m/s, (3) 0.57 m/s, (4) 0.88 m/s, and (5) 1.46 m/s. The average (± SD) speed that distinguished between the categories was 0.09 ± 0.01 m/s (1 vs 2), 0.15 ± 0.08 m/s (2 vs 3), 0.44 ± 0.14 m/s (3 vs 4), and 0.70 ± 0.13 m/s (4 vs 5). The averaged sensitivity and specificity were above 0.98 and 0.94, respectively. Conclusion. In subjects with spinal cord injury, the preferred walking speed as assessed in the clinic can be used to estimate functional ambulation during daily life. The walking speed can distinguish between ambulation categories with high sensitivity and specificity.

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Using Inertial Sensors to Quantify Postural Sway and Gait Performance during the Tandem Walking Test

Sensors ◽

10.3390/s19040751 ◽

2019 ◽

Vol 19 (4) ◽

pp. 751 ◽

Cited By ~ 2

Author(s):

Kyoung Kim ◽

Yoav Gimmon ◽

Jennifer Millar ◽

Michael Schubert

Keyword(s):

Inertial Sensors ◽

Postural Sway ◽

Upper Body ◽

Lower Body ◽

Gait Control ◽

Walking Test ◽

Gait Performance ◽

Eyes Closed ◽

Vestibular Hypofunction ◽

Eyes Open

Vestibular dysfunction typically manifests as postural instability and gait irregularities, in part due to inaccuracies in processing spatial afference. In this study, we have instrumented the tandem walking test with multiple inertial sensors to easily and precisely investigate novel variables that can distinguish abnormal postural and gait control in patients with unilateral vestibular hypofunction. Ten healthy adults and five patients with unilateral vestibular hypofunction were assessed with the tandem walking test during eyes open and eyes closed conditions. Each subject donned five inertial sensors on the upper body (head, trunk, and pelvis) and lower body (each lateral malleolus). Our results indicate that measuring the degree of balance and gait regularity using five body-worn inertial sensors during the tandem walking test provides a novel quantification of movement that identifies abnormalities in patients with vestibular impairment.

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Is the FINDRISC Tool Useful in Screening Type 2 Diabetes and Metabolic Syndrome in an African Setting? Experience among Young Adults in Urban Tanzania

Diabetology ◽

10.3390/diabetology2040022 ◽

2021 ◽

Vol 2 (4) ◽

pp. 240-249

Author(s):

Evangelista Kenan Malindisa ◽

Emmanuel Balandya ◽

Fredirick Mashili ◽

Marina Njelekela

Keyword(s):

Metabolic Syndrome ◽

Young Adults ◽

Sensitivity And Specificity ◽

Adult Population ◽

Tolerance Test ◽

Screening Tools ◽

Oral Glucose ◽

Cross Sectional ◽

Young Adult Population ◽

Low Sensitivity

Background: Simple and less costly screening tools are needed to combat the rising non-communicable diseases epidemic. This study aimed to evaluate the utility of The Finnish Diabetes Risk Score (FINDRISC) as a screening tool for prediabetes, T2D, and metabolic syndrome (MetS) in a population of young adults in urban Mwanza, Tanzania. Methods: A cross-sectional community-based study was conducted among participants aged 18–35 years. The FINDRISC questionnaire was used to collect data and compute the FINDRISC scores for each participant. Socio-demographic, anthropometric, blood glucose, and lipid profiles data were collected accordingly. Results: A total of 259 participants were recruited into the study. The median age was 21 years (IQR 19–27), and more than half 60.2% (156) were females. In total, 32.8% (85) of the participants had at least a slightly elevated risk of developing T2D in 10 years’ time. Compared to the Oral Glucose Tolerance Test (OGTT), FINDRISC had a sensitivity and specificity of 39.1% and 69.2%, respectively (aROC = 0.5). The FINDRISC score significantly correlated with MetS (p = 0.001). Conclusion: In this study, FINDRISC has shown low sensitivity and specificity in the screening of pre-diabetes/T2D. However, it has potential utility in the screening of MetS in a young-adult population.

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Applying Item Response Theory Modeling to Identify Social (Pragmatic) Communication Disorder

Journal of Speech Language and Hearing Research ◽

10.1044/2020_jslhr-19-00284 ◽

2020 ◽

Vol 63 (6) ◽

pp. 1916-1932 ◽

Cited By ~ 1

Author(s):

Haiying Yuan ◽

Christine Dollaghan

Keyword(s):

Item Response Theory ◽

Item Response ◽

Sensitivity And Specificity ◽

Social Communication ◽

National Database ◽

Communication Disorder ◽

Social Communication Questionnaire ◽

Autism Research ◽

The Social ◽

Pragmatic Communication

Purpose No diagnostic tools exist for identifying social (pragmatic) communication disorder (SPCD), a new Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition category for individuals with social communication deficits but not the repetitive, restricted behaviors and interests (RRBIs) that would qualify them for a diagnosis of autism spectrum disorder (ASD). We explored the value of items from a widely used screening measure of ASD for distinguishing SPCD from typical controls (TC; Aim 1) and from ASD (Aim 2). Method We applied item response theory (IRT) modeling to Social Communication Questionnaire–Lifetime ( Rutter, Bailey, & Lord, 2003 ) records available in the National Database for Autism Research. We defined records from putative SPCD ( n = 54), ASD ( n = 278), and TC ( n = 274) groups retrospectively, based on National Database for Autism Research classifications and Autism Diagnostic Interview–Revised responses. After assessing model assumptions, estimating model parameters, and measuring model fit, we identified items in the social communication and RRBI domains that were maximally informative in differentiating the groups. Results IRT modeling identified a set of seven social communication items that distinguished SPCD from TC with sensitivity and specificity > 80%. A set of five RRBI items was less successful in distinguishing SPCD from ASD (sensitivity and specificity < 70%). Conclusion The IRT modeling approach and the Social Communication Questionnaire–Lifetime item sets it identified may be useful in efforts to construct screening and diagnostic measures for SPCD.

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