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However, unaided eye movement assessments lack granularity. Although videooculography (VOG) improves diagnostic accuracy, resource intensiveness precludes its broad use. To bridge this care gap, we here validate a framework for smartphone video-based nystagmography capitalizing on recent computer vision advances.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A convolutional neural network was fine-tuned for pupil tracking using\u2009&gt;\u2009550 annotated frames: ConVNG. In a cross-sectional approach, slow-phase velocity of optokinetic nystagmus was calculated in 10 subjects using ConVNG and VOG. Equivalence of accuracy and precision was assessed using the \u201ctwo one-sample<jats:italic>t<\/jats:italic>-test\u201d (TOST) and Bayesian interval-null approaches. ConVNG was systematically compared to OpenFace and MediaPipe as computer vision (CV) benchmarks for gaze estimation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>ConVNG tracking accuracy reached 9\u201315% of an average pupil diameter. In a fully independent clinical video dataset, ConVNG robustly detected pupil keypoints (median prediction confidence 0.85). SPV measurement accuracy was equivalent to VOG (TOST<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.017; Bayes factors (BF)\u2009&gt;\u200924). ConVNG, but not MediaPipe, achieved equivalence to VOG in all SPV calculations. Median precision was 0.30\u00b0\/s for ConVNG, 0.7\u00b0\/s for MediaPipe and 0.12\u00b0\/s for VOG. ConVNG precision was significantly higher than MediaPipe in vertical planes, but both algorithms\u2019 precision was inferior to VOG.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>ConVNG enables offline smartphone video nystagmography with an accuracy comparable to VOG and significantly higher precision than MediaPipe, a benchmark computer vision application for gaze estimation. This serves as a blueprint for highly accessible tools with potential to accelerate progress toward precise and personalized Medicine.<\/jats:p><\/jats:sec>","DOI":"10.1007\/s00415-022-11493-1","type":"journal-article","created":{"date-parts":[[2022,11,24]],"date-time":"2022-11-24T18:20:11Z","timestamp":1669314011000},"page":"2518-2530","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":43,"title":["Smartphone video nystagmography using convolutional neural networks: ConVNG"],"prefix":"10.1007","volume":"270","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3695-1268","authenticated-orcid":false,"given":"Maximilian U.","family":"Friedrich","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erich","family":"Schneider","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Miriam","family":"Buerklein","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Johannes","family":"Taeger","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Johannes","family":"Hartig","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jens","family":"Volkmann","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert","family":"Peach","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel","family":"Zeller","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2022,11,23]]},"reference":[{"key":"11493_CR1","doi-asserted-by":"publisher","unstructured":"John LR, DS Zee (2015) The neurology of eye movements, 5 edn, Contemporary Neurology Series (New York, 2015; online edn, Oxford Academic, 1 June 2015). https:\/\/doi.org\/10.1093\/med\/9780199969289.001.0001","DOI":"10.1093\/med\/9780199969289.001.0001"},{"key":"11493_CR2","doi-asserted-by":"publisher","first-page":"74","DOI":"10.1097\/WCO.0000000000000517","volume":"31","author":"AA Tarnutzer","year":"2018","unstructured":"Tarnutzer AA, Straumann D (2018) Nystagmus. 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