Assessment Tools and Diagnostic Test

In this Discussion, you will consider the validity and reliability of different assessment tools and
diagnostic tests. You will explore issues such as sensitivity, specificity, and positive and negative
predictive values.

Assessment Tools and Diagnostic Test

The Dix-Hallpike test, also known as Nylen-Barany test, is a diagnostic maneuver whose
use is detecting Benigh Paraxysmal Positional Vertigo. When conducting the test, a patient is
required to sit upright and have the legs extended. The patient’s head has to be rotated at around
5 degrees. Then the patient has to lie down backwards hastily with the head at 20 degrees of
extension Viirre, Purcell & Baloh, 2012).The provider observes the patient’s eyes for 45 minutes
as there is a characteristic five to ten seconds latency period prior to the appearance of a
nystagmus. A positive test is indicated by a rotational nystagmus in the ear that is nearer to the
ground. In the presence of a positive test, a rotator nystagmus phase is usually towards the
affected ear. The direction of the fast phase is denoted by the eye’s top rotating clockwise or
counter-clockwise (Viirre, Purcell & Baloh, 2012).
Some individuals deny taking this test based on physical limitations. Discomfort
associated with the test is usually due to vertigo and nausea that is likely to result. Its sensitivity
is not 100%. Some people with a history of BPPV never indicate a positive test result. The test
has 79% projected sensitivity in addition to a 75% probable specificity Viirre, Purcell & Baloh,
2012). The occiput’s plane and speed of the maneuver are likely to affect the test’s results. There
are high chances of patients being tensed about producing the symptoms of vertigo which


influences the brisk passive movements of the test. The maneuver of this test is limited by
musculoskeletal as well as obesity issues.
Some of the factors that contribute to its wide use in health are the ease of use since a
single examiner can have it administered, and it is cheap. It should not be performed more than
once as demonstrating observable nystagmus is challenging (Viirre, Purcell & Baloh, 2012).



Viirre, E., Purcell, I., & Baloh, R. W. (2012). The Dix‐Hallpike Test and The Canalith
Repositioning Maneuver. The Laryngoscope, 115(1), 184-187.

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