European Archives of Oto-Rhino-Laryngology

, Volume 273, Issue 12, pp 4273–4279 | Cite as

Reliability and comparison of gain values with occurrence of saccades in the EyeSeeCam video head impulse test (vHIT)

  • Leise Elisabeth Hviid KorsagerEmail author
  • Jesper Hvass Schmidt
  • Christian Faber
  • Jens Højberg Wanscher


The vHIT (video head impulse test) investigates the vestibular function in two ways: a VOR (vestibulo-ocular reflex) gain value and a head impulse diagram. From the diagram covert and overt saccades can be detected. Evaluation of the vestibular function based on vHIT depends on both parameters. There is a lack of knowledge regarding the reliability of the two parameters. The objective was to investigate the reliability of vHIT by comparing gain values between examiners on the same subjects, and to see how differences affected the occurrence of saccades. Subjects: 25 subjects who had undergone cochlear implant (CI) surgery. Subjects were tested using the vHIT by two of four different examiners. Two judges interpreted the occurrence of saccades in the diagram. Main Outcome Measures: VOR gain values and the occurrence of saccades in the diagram. Differences in gain values between examiners varied from 0.2 to 0.58 with an average of 0.14 (95 % CI 0.12–0.16) on the right ear and 0.17 (95 % CI 0.15–0.19) on the left ear. Occurrences of saccades in the same patient were reproduced in 93 % of the cases by all examiners. Kappa’s coefficient on the occurrence of saccades was 0.83. Interclass correlation coefficient (ICC) of the gain values between examiners ranged from 0.62 to 0.70. Differences in gain values amongst examiners did not seem to affect the occurrence of saccades in the same patient. The occurrence of saccades, therefore, seems to be more reliable than the gain value in the evaluation of the vestibular function. Interpretation of vHIT results should, therefore, first depend on the occurrence of saccades and second on the gain value.


Video head impulse test vHIT Saccades Vestibulo-ocular reflex VOR EyeSeeCam Vestibulopathy 


Compliance with ethical standards

The study is sponsored by the Oticon Foundation, MED-EL G.m.b.H and Danaflex a/s.

Conflict of interest

The authors declare no other conflict of interest.

All procedures performed in this study were in accordance with the ethical standards of the Regional Committees on Health Research Ethics for Southern Denmark.

Informed consent was obtained from all individual participants included in the study.


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Copyright information

© Springer-Verlag Berlin Heidelberg 2016

Authors and Affiliations

  • Leise Elisabeth Hviid Korsager
    • 1
    Email author
  • Jesper Hvass Schmidt
    • 1
    • 2
    • 3
  • Christian Faber
    • 1
  • Jens Højberg Wanscher
    • 1
  1. 1.Department of ENT Head and Neck SurgeryOdense University HospitalOdense CDenmark
  2. 2.Department of AudiologyOdense University HospitalOdense CDenmark
  3. 3.Department of Clinical ResearchOdense University HospitalOdense CDenmark

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