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ArticleScientific reports2025

Interobserver agreement in BPPV diagnosis using eye movement recordings.

Ali A Melliti, Rajneesh Bhandari, Anita Bhandari, Andrea Castellucci, Marie-Cecile Gerards, Bre Myers, Vipin Ola, Peter Oostenbrink, Hans Van Kampen, Sophie Vanbelle and 1 more

Abstract read
In one paragraph

Article in Scientific reports, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–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

1 citing paper in PubMed.

  1. 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

11 authors.

Ali A MellitiDivision of Vestibular Disorders, Department of Otorhinolaryngology and Head & Neck Surgery, School for Mental Health and Neuroscience, Maastricht University Medical Center, Maastricht, 6229 HX, The Netherlands. ali.melliti@mumc.nl.
Rajneesh BhandariNeuroEquilibrium Diagnostic Systems Pvt Ltd., Jaipur, India.
Anita BhandariVertigo and Ear Clinic, Jaipur, India.
Andrea CastellucciENT Unit, Department of Surgery, Azienda USL-IRCCS, Reggio Emilia, Italy.
Marie-Cecile GerardsDivision of Vestibular Disorders, Department of Otorhinolaryngology and Head & Neck Surgery, School for Mental Health and Neuroscience, Maastricht University Medical Center, Maastricht, 6229 HX, The Netherlands.
Bre MyersOsborne Audiology, CNHP, Drexel University, Elkins Park, PA, USA.
Vipin OlaApex Hospitals, Malviya Nagar, Jaipur, India.
Peter OostenbrinkApeldoorn Dizziness Centre, Gelre Ziekenhuizen, Apeldoorn, Gelderland, The Netherlands.
Hans Van KampenApeldoorn Dizziness Centre, Gelre Ziekenhuizen, Apeldoorn, Gelderland, The Netherlands.
Sophie VanbelleMethodology and Statistics, CAPHRI, Maastricht University, P. Debyeplein, 1, Maastricht, 6229 HA, The Netherlands.
Raymond van de BergDivision of Vestibular Disorders, Department of Otorhinolaryngology and Head & Neck Surgery, School for Mental Health and Neuroscience, Maastricht University Medical Center, Maastricht, 6229 HX, The Netherlands.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

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.

Indexed as

Benign Paroxysmal Positional VertigoEye MovementsObserver VariationVestibular SystemHumansBPPVInterobserver agreementNystagmusTelemedicineVertigo

Identifiers

PMID40820099
PMCPMC12358603

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