A Proposal for certification of vestibular testing and laboratories

Timothy C. Hain, MD

Professor of Neurology, Otolaryngology, and Physical Therapy/Human Movement Science, Northwestern University Medical School, Chicago IL, USA.

Dr. Hain has run many vestibular laboratories in the last 20 years including the laboratory at Johns Hopkins Hospital, Northwestern Memorial Hospital (in Chicago), and a laboratory in his private practice at Chicago Dizziness and Hearing. He has written several articles on vestibular testing (see end). Dr. Hain is very familiar with all aspects of vestibular testing.

EMAIL ADDRESS: t-hain@northwestern.edu

Page last modified: June 18, 2009

Recently there has been an upsurge in vestibular testing fraud as well as an ongoing problem with poorly performed testing relevant to dizzienss. This page is a proposal of a mechanism to correct this problem.

Proposal for Certification of Vestibular Testing

Certification of vestibular laboratories -- required for billing

• Staff -- require a certified technician (see below)
• Equipment -- require calibrated equipment meeting basic criteria
  • Water calorics
  • VEMP testing using calibrated equipment
  • Posturography using computerized dynamic equipment (not foam/dome)
• Oversight
  • Laboratory director having board certification in either
    • Otolaryngology
    • Neurology

Certification procedure for vestibular testing technicians -- required for laboratory certification.

• Groups eligible to sit for the examination
  • Person with appropriate training (one or more)
    • Current person doing vestibular testing (including audiologists and PT's)
    • Undergraduate degree or above in biology
    • Doctoral degree in medicine
    • Relevant college level courses
  • Audiologists
  • Physical therapists
• Content of examination
  • Didactic content
    • Inner ear anatomy and physiology, and disorders
      • Semicircular canals
      • Otoliths
      • Vestibular nerve
    • Brain anatomy and physology relevant to balance
      • Cerebellum -- function and disorders
      • Basal ganglia -- function and disorders
      • Brainstem
    • Body anatomy and physiology relevant to balance
      • Vision
      • Vestibular
      • Proprioceptive
  • Practical Examination -- show competence in performing these studies.
    • ENG
    • VEMP
    • ECOG
    • ABR
    • Posturography
    • Rotatory Chair testing

References:

• Hain TC: Oculomotor Testing: Background. in Handbook of Balance Function Testing (Ed. Jacobson and Newman), Mosby, 1992 (2nd edition)
• Hain TC: Oculomotor Testing: Interpretation. in Handbook of Balance Function Testing (Ed. Jacobson and Newman), Mosby, 1992 (2nd edn)
• Fife TD, Tusa RJ, Furman JM, Zee DS, Frohman E, Baloh RW, Hain T, Goebel J, Demer J, Eviatar L. Assessment: vestibular testing techniques in adults and children: Report of the therapeutic and technology subcommittee of the American Academy of Neurology. Neurology, 2000, 55:10, 1431-1441