Among 42 people with vestibular disorders, Mini-BESTest had poor-to-modest discrimination for fall risk (AUC 0.69). A cut-off of ≤23 yielded 92.3% sensitivity but 44.8% specificity, potentially missing few at-risk patients while producing many false positives. It should not be used as a stand-alone diagnosis.
Key findings
- AUC was 0.69. At ≤23, sensitivity was 92.3%, specificity 44.8%, LR+ 1.67 and LR- 0.17. The LR- supports using a higher score to reduce concern, whereas the weak LR+ cannot confirm risk. Only reactive postural control showed a significant exploratory discriminatory trend under bootstrap (95% CI 0.516-0.823).
Why this matters globally
Falls are a major burden and vestibular patients are vulnerable. A sensitive short test could triage rehabilitation in constrained services if the threshold is externally validated and linked to prospective falls.
Thai researcher contribution
Chulalongkorn University physical-therapy and otoneurology teams generated a population-specific threshold rather than directly borrowing cut-offs from other groups.
Limitations to consider
Only 42 participants were included, and the cut-off was derived and evaluated in the same sample, risking optimism. The reference was a composite rather than prospective falls. Low specificity requires follow-up assessment, and subscore findings were exploratory with wide uncertainty.