Interobserver agreement in BPPV diagnosis using eye movement recordings
Abstract Benign Paroxysmal Positional Vertigo (BPPV) is one of the most prevalent peripheral vestibular disorders seen in specialized dizziness clinics. Despite being a well-understood condition with effective treatment options, BPPV remains associated with significant diagnostic delays and healthca...
Saved in:
| Main Authors: | , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Nature Portfolio
2025-08-01
|
| Series: | Scientific Reports |
| Subjects: | |
| Online Access: | https://doi.org/10.1038/s41598-025-15807-x |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1849340058898792448 |
|---|---|
| author | Ali A. Melliti Rajneesh Bhandari Anita Bhandari Andrea Castellucci Marie-Cecile Gerards Bre Myers Vipin Ola Peter Oostenbrink Hans Van Kampen Sophie Vanbelle Raymond van de Berg |
| author_facet | Ali A. Melliti Rajneesh Bhandari Anita Bhandari Andrea Castellucci Marie-Cecile Gerards Bre Myers Vipin Ola Peter Oostenbrink Hans Van Kampen Sophie Vanbelle Raymond van de Berg |
| author_sort | Ali A. Melliti |
| collection | DOAJ |
| description | Abstract Benign Paroxysmal Positional Vertigo (BPPV) is one of the most prevalent peripheral vestibular disorders seen in specialized dizziness clinics. Despite being a well-understood condition with effective treatment options, BPPV remains associated with significant diagnostic delays and healthcare costs. If proven reliable, telemedicine approaches could help address these challenges by improving diagnostic accessibility and efficiency. To investigate the interobserver agreement in BPPV diagnosis, when using eye movement recordings. Six vestibular medicine specialists (Specialist 1, 2, 3, 4, 5, 6) were recruited to participate in this study. The specialists were asked to evaluate the recordings of 240 patient cases who underwent assessment for BPPV (first assessment). After viewing the recordings of each case, they were required to make a BPPV diagnosis. Five specialists (2, 3, 4, 5, 6) agreed to repeat the procedure twice, to additionally evaluate the intraobserver agreement (second assessment). The proportion of agreement and Cohen’s kappa were calculated for both interobserver and intraobserver agreement. Furthermore, agreement with the original diagnoses was evaluated. The interobserver agreement between experts was fair to moderate with a Cohen’s kappa value of 0.40 (CI 95% [0.35, 0.45]) and a proportion of agreement of 60% (CI 95% [54, 67]). Specialists 2, 4, and 5 exhibited substantial intraobserver agreement. In contrast, Specialist 3 demonstrated fair intraobserver agreement, while Specialist 6 showed almost perfect intraobserver agreement. Regarding the first assessment, agreement with the original diagnoses ranged from fair to substantial, with kappa values between 0.40 and 0.70, and corresponding percentages between 58 and 78%. Similar results were observed for the second assessment. The interobserver agreement between specialists diagnosing BPPV using eye movement recordings, was fair to moderate. The suboptimal agreement could be related to missing clinical information (e.g. patient history and symptoms during positional maneuvers). Future studies should incorporate this information and reassess interobserver agreement. |
| format | Article |
| id | doaj-art-15c2a61da52e48b6a4df7b5d75bbc96a |
| institution | Kabale University |
| issn | 2045-2322 |
| language | English |
| publishDate | 2025-08-01 |
| publisher | Nature Portfolio |
| record_format | Article |
| series | Scientific Reports |
| spelling | doaj-art-15c2a61da52e48b6a4df7b5d75bbc96a2025-08-20T03:44:00ZengNature PortfolioScientific Reports2045-23222025-08-011511710.1038/s41598-025-15807-xInterobserver agreement in BPPV diagnosis using eye movement recordingsAli A. Melliti0Rajneesh Bhandari1Anita Bhandari2Andrea Castellucci3Marie-Cecile Gerards4Bre Myers5Vipin Ola6Peter Oostenbrink7Hans Van Kampen8Sophie Vanbelle9Raymond van de Berg10Division of Vestibular Disorders, Department of Otorhinolaryngology and Head & Neck Surgery, School for Mental Health and Neuroscience, Maastricht University Medical CenterNeuroEquilibrium Diagnostic Systems Pvt Ltd.Vertigo and Ear ClinicENT Unit, Department of Surgery, Azienda USL-IRCCSDivision of Vestibular Disorders, Department of Otorhinolaryngology and Head & Neck Surgery, School for Mental Health and Neuroscience, Maastricht University Medical CenterOsborne Audiology, CNHP, Drexel UniversityApex HospitalsApeldoorn Dizziness Centre, Gelre ZiekenhuizenApeldoorn Dizziness Centre, Gelre ZiekenhuizenMethodology and Statistics, CAPHRI, Maastricht UniversityDivision of Vestibular Disorders, Department of Otorhinolaryngology and Head & Neck Surgery, School for Mental Health and Neuroscience, Maastricht University Medical CenterAbstract Benign Paroxysmal Positional Vertigo (BPPV) is one of the most prevalent peripheral vestibular disorders seen in specialized dizziness clinics. Despite being a well-understood condition with effective treatment options, BPPV remains associated with significant diagnostic delays and healthcare costs. If proven reliable, telemedicine approaches could help address these challenges by improving diagnostic accessibility and efficiency. To investigate the interobserver agreement in BPPV diagnosis, when using eye movement recordings. Six vestibular medicine specialists (Specialist 1, 2, 3, 4, 5, 6) were recruited to participate in this study. The specialists were asked to evaluate the recordings of 240 patient cases who underwent assessment for BPPV (first assessment). After viewing the recordings of each case, they were required to make a BPPV diagnosis. Five specialists (2, 3, 4, 5, 6) agreed to repeat the procedure twice, to additionally evaluate the intraobserver agreement (second assessment). The proportion of agreement and Cohen’s kappa were calculated for both interobserver and intraobserver agreement. Furthermore, agreement with the original diagnoses was evaluated. The interobserver agreement between experts was fair to moderate with a Cohen’s kappa value of 0.40 (CI 95% [0.35, 0.45]) and a proportion of agreement of 60% (CI 95% [54, 67]). Specialists 2, 4, and 5 exhibited substantial intraobserver agreement. In contrast, Specialist 3 demonstrated fair intraobserver agreement, while Specialist 6 showed almost perfect intraobserver agreement. Regarding the first assessment, agreement with the original diagnoses ranged from fair to substantial, with kappa values between 0.40 and 0.70, and corresponding percentages between 58 and 78%. Similar results were observed for the second assessment. The interobserver agreement between specialists diagnosing BPPV using eye movement recordings, was fair to moderate. The suboptimal agreement could be related to missing clinical information (e.g. patient history and symptoms during positional maneuvers). Future studies should incorporate this information and reassess interobserver agreement.https://doi.org/10.1038/s41598-025-15807-xInterobserver agreementBPPVTelemedicineNystagmusVertigo |
| spellingShingle | Ali A. Melliti Rajneesh Bhandari Anita Bhandari Andrea Castellucci Marie-Cecile Gerards Bre Myers Vipin Ola Peter Oostenbrink Hans Van Kampen Sophie Vanbelle Raymond van de Berg Interobserver agreement in BPPV diagnosis using eye movement recordings Scientific Reports Interobserver agreement BPPV Telemedicine Nystagmus Vertigo |
| title | Interobserver agreement in BPPV diagnosis using eye movement recordings |
| title_full | Interobserver agreement in BPPV diagnosis using eye movement recordings |
| title_fullStr | Interobserver agreement in BPPV diagnosis using eye movement recordings |
| title_full_unstemmed | Interobserver agreement in BPPV diagnosis using eye movement recordings |
| title_short | Interobserver agreement in BPPV diagnosis using eye movement recordings |
| title_sort | interobserver agreement in bppv diagnosis using eye movement recordings |
| topic | Interobserver agreement BPPV Telemedicine Nystagmus Vertigo |
| url | https://doi.org/10.1038/s41598-025-15807-x |
| work_keys_str_mv | AT aliamelliti interobserveragreementinbppvdiagnosisusingeyemovementrecordings AT rajneeshbhandari interobserveragreementinbppvdiagnosisusingeyemovementrecordings AT anitabhandari interobserveragreementinbppvdiagnosisusingeyemovementrecordings AT andreacastellucci interobserveragreementinbppvdiagnosisusingeyemovementrecordings AT mariececilegerards interobserveragreementinbppvdiagnosisusingeyemovementrecordings AT bremyers interobserveragreementinbppvdiagnosisusingeyemovementrecordings AT vipinola interobserveragreementinbppvdiagnosisusingeyemovementrecordings AT peteroostenbrink interobserveragreementinbppvdiagnosisusingeyemovementrecordings AT hansvankampen interobserveragreementinbppvdiagnosisusingeyemovementrecordings AT sophievanbelle interobserveragreementinbppvdiagnosisusingeyemovementrecordings AT raymondvandeberg interobserveragreementinbppvdiagnosisusingeyemovementrecordings |