Evaluation of posturography in the detection of malingering subjects.
Identifieur interne : 001424 ( Main/Exploration ); précédent : 001423; suivant : 001425Evaluation of posturography in the detection of malingering subjects.
Auteurs : G A Krempl [États-Unis] ; R A DobieSource :
- The American journal of otology [ 0192-9763 ] ; 1998.
Descripteurs français
- KwdFr :
- MESH :
- diagnostic : Maladies vestibulaires, Simulation.
- méthodes : Diagnostic assisté par ordinateur.
- Adulte, Adulte d'âge moyen, Diagnostic différentiel, Humains, Méthode en double aveugle, Posture, Études prospectives.
English descriptors
- KwdEn :
- MESH :
- diagnosis : Malingering, Vestibular Diseases.
- methods : Diagnosis, Computer-Assisted.
- Adult, Diagnosis, Differential, Double-Blind Method, Humans, Middle Aged, Posture, Prospective Studies.
Abstract
OBJECTIVE
This study aimed to test the performance of proposed methods for detecting malingering subjects on computerized dynamic posturography using one subject group in three situations (normal, malingering, vestibular weakness).
STUDY DESIGN
The study design was a prospective, blinded study.
SETTING
The study was conducted at a university hospital.
PATIENTS
Volunteer subjects aged 20-59 years of age participated.
INTERVENTIONS
Computerized dynamic posturography was performed under three situations: best effort, faking vestibular weakness, and transient induced vestibular weakness with bilateral simultaneous caloric irrigation.
MAIN OUTCOME MEASURES
Measured was identification of situation (normal, malingering, induced vestibular weakness) by each of three detection methods: blinded clinical scoring, a set of formulae, and a set of variables (the latter two methods proposed previously by other investigators).
RESULTS
Each method performed well. In three-way discrimination, the formulae and clinical scoring each correctly identified approximately 75% of trials. In two-way discrimination (malingering vs. induced vestibular weakness), the best combination of variables slightly outperformed clinical scoring (0.93 vs. 0.88 ROC [receiver operating characteristic] curve area).
CONCLUSIONS
Computerized dynamic posturography can distinguish malingering in normal subjects from trials performed with best effort or after binaural simultaneous caloric irrigation. The accuracy of blinded clinical scoring was comparable to that of two objective detection methods.
PubMed: 9752970
Affiliations:
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Le document en format XML
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<affiliation wicri:level="1"><nlm:affiliation>Department of Otolaryngology-Head and Neck Surgery, The University of Texas Health Science Center, San Antonio 78284-7777, USA.</nlm:affiliation>
<country xml:lang="fr">États-Unis</country>
<wicri:regionArea>Department of Otolaryngology-Head and Neck Surgery, The University of Texas Health Science Center, San Antonio 78284-7777</wicri:regionArea>
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<author><name sortKey="Dobie, R A" sort="Dobie, R A" uniqKey="Dobie R" first="R A" last="Dobie">R A Dobie</name>
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<profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Adult (MeSH)</term>
<term>Diagnosis, Computer-Assisted (methods)</term>
<term>Diagnosis, Differential (MeSH)</term>
<term>Double-Blind Method (MeSH)</term>
<term>Humans (MeSH)</term>
<term>Malingering (diagnosis)</term>
<term>Middle Aged (MeSH)</term>
<term>Posture (MeSH)</term>
<term>Prospective Studies (MeSH)</term>
<term>Vestibular Diseases (diagnosis)</term>
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<keywords scheme="KwdFr" xml:lang="fr"><term>Adulte (MeSH)</term>
<term>Adulte d'âge moyen (MeSH)</term>
<term>Diagnostic assisté par ordinateur (méthodes)</term>
<term>Diagnostic différentiel (MeSH)</term>
<term>Humains (MeSH)</term>
<term>Maladies vestibulaires (diagnostic)</term>
<term>Méthode en double aveugle (MeSH)</term>
<term>Posture (MeSH)</term>
<term>Simulation (diagnostic)</term>
<term>Études prospectives (MeSH)</term>
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<keywords scheme="MESH" qualifier="diagnosis" xml:lang="en"><term>Malingering</term>
<term>Vestibular Diseases</term>
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<keywords scheme="MESH" qualifier="diagnostic" xml:lang="fr"><term>Maladies vestibulaires</term>
<term>Simulation</term>
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<keywords scheme="MESH" qualifier="méthodes" xml:lang="fr"><term>Diagnostic assisté par ordinateur</term>
</keywords>
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<term>Diagnosis, Differential</term>
<term>Double-Blind Method</term>
<term>Humans</term>
<term>Middle Aged</term>
<term>Posture</term>
<term>Prospective Studies</term>
</keywords>
<keywords scheme="MESH" xml:lang="fr"><term>Adulte</term>
<term>Adulte d'âge moyen</term>
<term>Diagnostic différentiel</term>
<term>Humains</term>
<term>Méthode en double aveugle</term>
<term>Posture</term>
<term>Études prospectives</term>
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<front><div type="abstract" xml:lang="en"><p><b>OBJECTIVE</b>
</p>
<p>This study aimed to test the performance of proposed methods for detecting malingering subjects on computerized dynamic posturography using one subject group in three situations (normal, malingering, vestibular weakness).</p>
</div>
<div type="abstract" xml:lang="en"><p><b>STUDY DESIGN</b>
</p>
<p>The study design was a prospective, blinded study.</p>
</div>
<div type="abstract" xml:lang="en"><p><b>SETTING</b>
</p>
<p>The study was conducted at a university hospital.</p>
</div>
<div type="abstract" xml:lang="en"><p><b>PATIENTS</b>
</p>
<p>Volunteer subjects aged 20-59 years of age participated.</p>
</div>
<div type="abstract" xml:lang="en"><p><b>INTERVENTIONS</b>
</p>
<p>Computerized dynamic posturography was performed under three situations: best effort, faking vestibular weakness, and transient induced vestibular weakness with bilateral simultaneous caloric irrigation.</p>
</div>
<div type="abstract" xml:lang="en"><p><b>MAIN OUTCOME MEASURES</b>
</p>
<p>Measured was identification of situation (normal, malingering, induced vestibular weakness) by each of three detection methods: blinded clinical scoring, a set of formulae, and a set of variables (the latter two methods proposed previously by other investigators).</p>
</div>
<div type="abstract" xml:lang="en"><p><b>RESULTS</b>
</p>
<p>Each method performed well. In three-way discrimination, the formulae and clinical scoring each correctly identified approximately 75% of trials. In two-way discrimination (malingering vs. induced vestibular weakness), the best combination of variables slightly outperformed clinical scoring (0.93 vs. 0.88 ROC [receiver operating characteristic] curve area).</p>
</div>
<div type="abstract" xml:lang="en"><p><b>CONCLUSIONS</b>
</p>
<p>Computerized dynamic posturography can distinguish malingering in normal subjects from trials performed with best effort or after binaural simultaneous caloric irrigation. The accuracy of blinded clinical scoring was comparable to that of two objective detection methods.</p>
</div>
</front>
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