Document Detail


A new set of criteria for evaluating malingering in work-related vestibular injury.
MedLine Citation:
PMID:  16015169     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To develop and use a set of criteria using computerized dynamic posturography results to detect aphysiologic behavior in patients with complaints of imbalance, and to compare the efficacy of this system with present quantitative techniques and with subjective methods of evaluating malingerers. STUDY DESIGN: Prospective study of two groups of sequentially referred patients complaining of dizziness and/or imbalance. SETTING: A tertiary and quaternary care ambulatory referral center. PATIENTS: Two groups of patients were studied. One was a group of patients who had suffered work-related head trauma and had subsequent complaints of dizziness and/or imbalance. The other was a group of patients referred for dizziness and/or imbalance who had no history of head trauma, work-related injury, or litigation procedures. INTERVENTIONS: Standard vestibular assessment including computerized dynamic posturography was carried out on all patients. MAIN OUTCOME MEASURES: All patients in both groups were scored for aphysiologic behavior using a quantified formula that has been used to detect malingerers, an analysis criterion using different aspects of computerized dynamic posturography performance that has been used for some time, and our newly developed nine-point scoring method. Results of all three methods were compared to determine the effectiveness of each one in detecting malingering behavior. RESULTS: Our nine-point protocol was effective in assessing patients in a consistent manner. Assessment using the quantitative formula in the literature raised suspicions of malingering in many patients with no known ulterior motives, some of whom had documented vestibular disease. Our criteria also evaluate other aspects of performance not evaluated by the presently used techniques. CONCLUSION: Our newly developed criteria are effective at evaluating the medicolegal patients from both the quantitative and qualitative viewpoints, and provide a more thorough assessment than has previously been available.
Authors:
A I Mallinson; N S Longridge
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Otology & neurotology : official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology     Volume:  26     ISSN:  1531-7129     ISO Abbreviation:  Otol. Neurotol.     Publication Date:  2005 Jul 
Date Detail:
Created Date:  2005-07-14     Completed Date:  2005-08-17     Revised Date:  2008-11-21    
Medline Journal Info:
Nlm Unique ID:  100961504     Medline TA:  Otol Neurotol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  686-90     Citation Subset:  IM    
Affiliation:
Neuro-otology Unit, Vancouver General Hospital, University of British Columbia, Vancouver, British Columbia, Canada. art@mallinson.ca
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MeSH Terms
Descriptor/Qualifier:
Adult
Craniocerebral Trauma / complications
Diagnosis, Computer-Assisted
Diagnosis, Differential
Dizziness / diagnosis*,  etiology
Female
Humans
Male
Malingering / diagnosis*
Middle Aged
Occupational Diseases / diagnosis*,  etiology
Postural Balance*
Posture
Practice Guidelines as Topic
Prospective Studies
Sensation Disorders / diagnosis*,  etiology
Vestibular Diseases / diagnosis*,  etiology
Vestibular Function Tests

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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