Evidence map›Paper›PMID 40447837›Full record

SynthesisJournal of neurology2025

Accuracy of video head impulse test in stroke diagnosis during acute vestibular syndrome: a systematic review with meta-analysis.

Nicola Ferri, Alessandro Bracci, Giacomo Metta Franceschelli, Giacomo Gnoli, Andrea Turolla, Paolo Pillastrini, Leonardo Manzari, Marco Tramontano

Abstract readSystematic ReviewMeta-Analysis
PubMed Publisher
In one paragraph

Synthesis in Journal of neurology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Review
  3. Review
  4. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Nicola FerriDepartment of Biomedical and Neuromotor Sciences (DIBINEM), University of Bologna, via Pelagio Palagi 9, 40138, Bologna, BO, Italy.
Alessandro BracciDepartment for Life Quality Studies (QUVI), University of Bologna, 47921, Rimini, Italy.
Giacomo Metta FranceschelliRehabilitation Unit, Maggiore Hospital AUSL Bologna, 40133, Bologna, Italy.
Giacomo GnoliDepartment of Biomedical and Neuromotor Sciences (DIBINEM), University of Bologna, via Pelagio Palagi 9, 40138, Bologna, BO, Italy.
Andrea TurollaDepartment of Biomedical and Neuromotor Sciences (DIBINEM), University of Bologna, via Pelagio Palagi 9, 40138, Bologna, BO, Italy.
Paolo PillastriniDepartment of Biomedical and Neuromotor Sciences (DIBINEM), University of Bologna, via Pelagio Palagi 9, 40138, Bologna, BO, Italy.
Leonardo ManzariMSA ENT Academy Center, 03043, Cassino, Italy.
Marco TramontanoDepartment of Biomedical and Neuromotor Sciences (DIBINEM), University of Bologna, via Pelagio Palagi 9, 40138, Bologna, BO, Italy. marco.tramontano@unibo.it.ORCID http://orcid.org/0000-0001-6034-0638

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundVertigo is a common symptom in people with acute stroke, leading to difficulty in the diagnostic process. This study aims to systematically report the accuracy of the video head impulse test (vHIT) for diagnosing stroke in individuals presenting to emergency departments with acute vertigo.

methodsData from MEDLINE, CENTRAL, CINAHL, SCOPUS, and gray literature were searched from inception to July 2024 without language limits. Independent researchers created a contingency table to record the number of true positives, false positives, true negatives, and false negatives. A bivariate analysis was performed to estimate the summary sensitivity and specificity. Subgroup and sensitivity analyses were conducted to explore the source of heterogeneity. A quality assessment was performed using the Quality Assessment of Diagnostic Test Accuracy Studies 2 tool.

results13 studies (905 participants) were included. EyeSeeCam (6/13) and Otometrics (6/13) were the most represented vHIT devices. The studies were of good quality, with the flow and timing being the more prevalent domain presenting a high risk of bias (7/13); however, there were no concerns about applicability. The vHIT had a specificity of 85% (95% CI, 61%-95%), sensitivity of 84% (95% CI, 70%-92%), positive likelihood ratio (LR) of 5.56 (95% CI, 2.00-15.47), negative LR of 0.18 (95% CI, 0.10-0.35), and diagnostic odd ratio of 30.23 (95% CI, 8.96-102.06), making this test particularly useful for ruling out strokes.

conclusionThis review highlights the value of vHIT as a complementary tool in early diagnosis of stroke. Thus, expertise in its use and interpretation should be promoted, and future primary studies are expected to refine and update this systematic review. Prospero registration CRD42024532776.

Indexed as

Head Impulse TestStrokeVertigoVestibular DiseasesVideo RecordingHumansSensitivity and SpecificityDizzinessEmergency serviceHead impulse testHospitalStrokeVertigo

Identifiers

PMID40447837

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.