{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,22]],"date-time":"2026-06-22T04:49:38Z","timestamp":1782103778029,"version":"3.54.5"},"reference-count":14,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,6,22]],"date-time":"2026-06-22T00:00:00Z","timestamp":1782086400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Neurol."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Although video head impulse testing (vHIT) is widely used to assess semicircular canal function, access to quantitative vestibular testing remains limited. Smartphone-based vHIT systems with goggle-based fixation have been described, but larger validation studies and improved fixation stability are needed. We evaluated a portable vHIT application using an iPod touch with an oral stabilization three-dimensional (3D)-printed mount to determine whether it detects laterality in unilateral vestibular hypofunction and is noninferior to a medical-grade device for a patient-level laterality endpoint.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Thirteen patients with unilateral vestibular hypofunction and 14 healthy volunteers underwent testing with the portable and medical-grade vHIT systems on the same day. The primary endpoint was the patient-level laterality difference, defined as the difference between unaffected and affected vestibulo-ocular reflex (VOR) gain. Noninferiority was assessed using the two-sided 95% confidence interval (CI) for the mean between-device difference with a prespecified margin of 0.15. Agreement was evaluated using Bland\u2013Altman analysis. Secondarily, absolute VOR gain agreement between devices was evaluated. False-positive classifications in healthy volunteers were assessed at the ear and subject levels using a gain threshold of &amp;lt;0.78.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Both systems showed higher VOR gains on the unaffected side (paired\n                      <jats:italic>t<\/jats:italic>\n                      -test: medical device,\n                      <jats:italic>p<\/jats:italic>\n                      \u202f=\u202f2.44\u202f\u00d7\u202f10\n                      <jats:sup>\u22127<\/jats:sup>\n                      ; portable vHIT,\n                      <jats:italic>p<\/jats:italic>\n                      \u202f=\u202f1.02\u202f\u00d7\u202f10\n                      <jats:sup>\u22128<\/jats:sup>\n                      ). Mean laterality difference was 0.518\u202f\u00b1\u202f0.180 for the medical-grade device and 0.453\u202f\u00b1\u202f0.118 for the portable system. The between-device difference was \u22120.065 (95% CI: \u22120.149 to 0.018), supporting noninferiority. Bland\u2013Altman analysis demonstrated a bias of \u22120.065, with 95% limits of agreement from \u22120.337 to 0.207. For absolute VOR gain, average between-device bias was small, but individual-ear agreement remained variable. In healthy volunteers, abnormal classifications occurred in 0 of 28 ears and 0 of 14 subjects with the medical-grade device, and in 2 of 28 ears (7.1%) and 2 of 14 participants (14.3%) with the portable system.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The portable vHIT system detected laterality in unilateral vestibular hypofunction and met noninferiority criteria relative to a medical-grade device. Larger studies are warranted to refine quality control and define individual-ear absolute VOR gain agreement.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fneur.2026.1831063","type":"journal-article","created":{"date-parts":[[2026,6,22]],"date-time":"2026-06-22T04:35:41Z","timestamp":1782102941000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Validation of a portable video head impulse test using an iPod touch and an oral stabilization three-dimensional (3D) - printed mount: a method-comparison study"],"prefix":"10.3389","volume":"17","author":[{"given":"Masao","family":"Noda","sequence":"first","affiliation":[{"name":"Department of Otorhinolaryngology, Mejiro University Ear Institute Clinic","place":["Saitama, Japan"]},{"name":"Department of Otolaryngology and Head and Neck Surgery, Jichi Medical University","place":["Tochigi, Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tatsuaki","family":"Kuroda","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology, Mejiro University Ear Institute Clinic","place":["Saitama, Japan"]},{"name":"Kuroda Ear, Nose and Throat Clinic","place":["Kumamoto, Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Akiko","family":"Umibe","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology, Mejiro University Ear Institute Clinic","place":["Saitama, Japan"]},{"name":"Department of Otorhinolaryngology, Head and Neck Surgery, Dokkyo Medical University Saitama Medical Center","place":["Saitama, Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yumi","family":"Dobashi","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology, Mejiro University Ear Institute Clinic","place":["Saitama, Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Reiko","family":"Tsunoda","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology, Mejiro University Ear Institute Clinic","place":["Saitama, Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiroaki","family":"Fushiki","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology, Mejiro University Ear Institute Clinic","place":["Saitama, Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,6,22]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"486","DOI":"10.1111\/j.1749-6632.2008.03730.x","article-title":"Impulsive testing of semicircular-canal function using video-oculography","volume":"1164","author":"Weber","year":"2009","journal-title":"Ann N Y Acad 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telehealth strategy for digital therapy beyond COVID-19: scoping review","volume":"11","author":"Noda","year":"2023","journal-title":"JMIR Mhealth Uhealth"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"e70015","DOI":"10.2196\/70015","article-title":"Monitoring nystagmus in a patient with vertigo using a commercial mini-infrared camera and 3D printer: cost-effectiveness evaluation and case report","volume":"9","author":"Sakazaki","year":"2025","journal-title":"JMIR Form Res"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"150","DOI":"10.1159\/000534543","article-title":"Development of a prototype video head impulse test system using an iPhone for screening of peripheral vestibular dysfunction","volume":"7","author":"Kuroda","year":"2023","journal-title":"Digit Biomark"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"467","DOI":"10.1097\/mao.0000000000001751","article-title":"Video head impulse test (vHIT): the role of corrective saccades in identifying 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Neurol"},{"key":"ref12","doi-asserted-by":"publisher","first-page":"3","DOI":"10.1177\/09574271251336143","article-title":"Vestibular asymmetry in caloric and video head impulse testing: Do we interpret it correctly?","volume":"36","author":"Striteska","year":"2026","journal-title":"J Vestib Res"},{"key":"ref13","doi-asserted-by":"publisher","first-page":"398","DOI":"10.1017\/cjn.2015.330","article-title":"The under-utilization of the head impulse test in the emergency department","volume":"43","author":"McDowell","year":"2016","journal-title":"Can J Neurol Sci"},{"key":"ref14","doi-asserted-by":"publisher","first-page":"1158","DOI":"10.1161\/STROKEAHA.111.000033","article-title":"Quantitative video-oculography to help diagnose stroke in acute vertigo and dizziness: toward an ECG for the eyes","volume":"44","author":"Newman-Toker","year":"2013","journal-title":"Stroke"}],"container-title":["Frontiers in Neurology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fneur.2026.1831063\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,22]],"date-time":"2026-06-22T04:35:53Z","timestamp":1782102953000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fneur.2026.1831063\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6,22]]},"references-count":14,"alternative-id":["10.3389\/fneur.2026.1831063"],"URL":"https:\/\/doi.org\/10.3389\/fneur.2026.1831063","relation":{},"ISSN":["1664-2295"],"issn-type":[{"value":"1664-2295","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,6,22]]},"article-number":"1831063"}}