29 April 2008
Screening for vestibular disorders: a study of clinicians' compliance with recommended practices
Sharon H. PolensekABCDEFG, Claire E. SterkADEG, Ronald J. TusaADEGMed Sci Monit 2008; 14(5): CR238-242 :: ID: 855748
Abstract
Background
Dizziness and vertigo are very common patient complaints encountered by clinicians in both primary as well as specialty care in otolaryngology and neurology. Vestibular impairment is an underlying cause in as many as 45% of people complaining of dizziness. Most causes of vestibular impairment can be effectively treated; however, the diagnosis is frequently missed. The aim of this study was to examine clinical assessments used by providers in evaluating dizzy patients in outpatient clinics and the emergency department.
Material and Method
Computerized medical records of all patients receiving an ICD-9 diagnosis code for dizziness, including benign paroxysmal positional vertigo, Meniere's disease, and vestibular hypofunction over a six-month period at the Atlanta VA Medical Center were reviewed.
Results
476 patients were identified and of these, 157 patients were included. Over two-thirds of providers (69%) used the patient's description of the dizziness for identifying the cause; however, significant variability was evident across disciplines, ranging from 84% of audiologists asking for a description of the dizziness to only 33% of geriatricians asking. 89% of providers did not evaluate a patient for BPPV by examining for positional nystagmus. Primary care clinicians referred 22% of dizzy patients to a specialist (neurotologist), geriatricians referred 17%, and emergency physicians referred only 16%.
Conclusions
Dizzy patients were not routinely screened for vestibular impairment based on available recommended practices, likely contributing to underdiagnosis and treatment. Results indicate a need for effective dissemination of guidelines to improve health care quality, increase awareness of medical risks, and enhance patient access to appropriate treatment.
Keywords: Vestibular Diseases - diagnosis, Vestibular Function Tests, Risk, Vertigo - diagnosis, Quality of Health Care, Primary Health Care - methods, Nystagmus, Physiologic, Meniere Disease - diagnosis, Medical Records Systems, Computerized, Diagnosis, Differential
Editorial
01 April 2024 : Editorial
Editorial: Forty Years of Waiting for Prevention and Cure of HIV Infection – Ongoing Challenges and Hopes for Vaccine Development and Overcoming Antiretroviral Drug ResistanceDOI: 10.12659/MSM.944600
Med Sci Monit 2024; 30:e944600
In Press
07 Mar 2024 : Clinical Research
Knowledge of and Attitudes Toward Clinical Trials: A Questionnaire-Based Study of 179 Male Third- and Fourt...Med Sci Monit In Press; DOI: 10.12659/MSM.943468
08 Mar 2024 : Animal Research
Modification of Experimental Model of Necrotizing Enterocolitis (NEC) in Rat Pups by Single Exposure to Hyp...Med Sci Monit In Press; DOI: 10.12659/MSM.943443
18 Apr 2024 : Clinical Research
Comparative Analysis of Open and Closed Sphincterotomy for the Treatment of Chronic Anal Fissure: Safety an...Med Sci Monit In Press; DOI: 10.12659/MSM.944127
08 Mar 2024 : Laboratory Research
Evaluation of Retentive Strength of 50 Endodontically-Treated Single-Rooted Mandibular Second Premolars Res...Med Sci Monit In Press; DOI: 10.12659/MSM.944110
Most Viewed Current Articles
17 Jan 2024 : Review article
Vaccination Guidelines for Pregnant Women: Addressing COVID-19 and the Omicron VariantDOI :10.12659/MSM.942799
Med Sci Monit 2024; 30:e942799
14 Dec 2022 : Clinical Research
Prevalence and Variability of Allergen-Specific Immunoglobulin E in Patients with Elevated Tryptase LevelsDOI :10.12659/MSM.937990
Med Sci Monit 2022; 28:e937990
16 May 2023 : Clinical Research
Electrophysiological Testing for an Auditory Processing Disorder and Reading Performance in 54 School Stude...DOI :10.12659/MSM.940387
Med Sci Monit 2023; 29:e940387
01 Jan 2022 : Editorial
Editorial: Current Status of Oral Antiviral Drug Treatments for SARS-CoV-2 Infection in Non-Hospitalized Pa...DOI :10.12659/MSM.935952
Med Sci Monit 2022; 28:e935952