RESPONSE TO "LACK OF DIAGNOSTIC VALUE OF HIGH-PASS NOISE MASKING OF AUDITORY BRAINSTEM RESPONSES IN MÉNIÈRE'S DISEASE BY CLAUDIA F. J. DE VALCK, GERD M. E. CLAES, FLORIS L. WUYTS, AND PAUL H. VAN DE HEYNING. OTOLOGY & NEUROTOLOGY 2007;28:700-7"

Abstract

In the recent paper “Lack of Diagnostic Value of High-Pass Noise Masking of Auditory Brainstem Responses in Meniere’s Disease” by De Valck et al. (2007), the authors concluded that, due to its low sensitivity (31%) and low specificity (28%), the ABR high-pass noise masking technique (Don et al., 2005), commercially known as CHAMP (Natus/Bio-logic Corp.), had “…no discriminative value in differentiating Meniere’s from non-MD subjects with otovestibular symptoms” (p. 706). In reviewing their data and analyses, we found errors that led to misleading and inappropriate conclusions. This response will briefly review the errors and suggest that once these errors are corrected, the revised values of 100% sensitivity and 80% specificity are consistent with the excellent sensitivity and specificity described in the original paper (Don et al., 2005). Before discussing the errors, it is important to note that the authors state, “…when only definite MD patients were included, and only the interpretable tests were used, a 100% sensitivity was obtained as in the study of Don et al. (11).” (p.705) In addition, they state, “…none of our definite MD patients had a test within normal ranges.” (p. 706) Thus, as in our study (Don et al., 2005), these authors found that in all the patients with definite Meniere’s disease (MD) and measurable responses, the test results were abnormal. So, what errors led De Valck et al. (2007) to their erroneous conclusion about the value of the CHAMP test?