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TECHNOLOGY: MINIMUM STANDARDS

At a minimum, assessment tools and/or testing devices must be reliable, include standardized protocols, provide specific and valid information, and have the sensitivity to detect the smallest clinically relevant changes in patient performance. This is especially true in the assessment and treatment of balance disorders where subtle changes in sensory, motor or CNS function can impact overall performance.

To provide meaningful clinical information, measurement tools utilized in the quantification of sensory and motor impairments must provide accurate data related to targeted performance capabilities, as well as a database that reflects the performance ranges of age-matched populations of asymptomatic (normal) subjects and populations with known diseases.

Clinical research literature characterizes the "accuracy" of a measurement tool by the following criteria:

  • Reliability
    Information obtained from a measurement tool should be reproducible across multiple test trials. The key assumption is that the measured performance capabilities of the patient do not change from one test session to the next as a function of testing error.
  • Sensitivity
    The measurement tool should be able to detect the smallest clinically relevant changes in patient performance. Performance changes might be associated with experience, disease processes, and/or intervening retraining efforts.
  • Validity
    The measurement tool must accurately reflect a patient's performance abilities relative to daily life tasks. A tool designed to measure balance, for example, should reflect performance abilities related to tasks requiring balance.
  • Specificity
    The measurement tool must be able to differentiate among many possible sensory, motor, and central adaptive impairments to balance. Test specificity is essential for accurate diagnosis and effective customization of treatment.

The validity, reliability, and specificity of assessment information provided by NeuroCom®, a division of Natus® System protocols has been documented extensively in published literature across a wide range of patient populations. The clinical literature has also shown NeuroCom System assessments to be sensitive and specific to impairments associated with pathology and normal aging, as well as the improvements associated with rehabilitation. The test-retest reliability of the assessments is well established. Further, the evidence supports the application and clinical value of the information provided by NeuroCom System assessment protocols in the treatment of patients with balance and dizziness disorders.