Τετάρτη 4 Ιουλίου 2018

Development and Preliminary Findings of the Dizziness Symptom Profile

Objectives: Dizziness, vertigo, and unsteadiness are common complaints of patients who present to primary care providers. These patients often are referred to otology for assessment and management. Unfortunately, there are a small number of specialists to manage these patients. However, there are several dizziness disorders that can be successfully managed by primary care providers if the disorder is properly identified. To assist in the identification of several of the most common dizziness disorders, we developed the dizziness symptom profile (DSP). The DSP is a self-report questionnaire designed to generate one or more differential diagnoses that can be combined with the patient’s case history and physical examination. Design: This report describes three investigations. Investigations 1 and 2 (i.e., exploratory and confirmatory investigations, N = 514) describe the development of the DSP. Investigation 3 (N = 195) is a validation study that describes the level of agreement between the DSP completed by the patient, and, the differential diagnosis of the otologist. Results: The final version of the DSP consists of 31 items. Preliminary findings suggest that the DSP is in agreement with the differential diagnoses of ear specialists for Meniere’s disease (100% agreement), vestibular migraine (95% agreement), and benign paroxysmal positional vertigo (82% agreement). Conclusions: Early results suggest that DSP may be useful in the creation of differential diagnoses for dizzy patients that can be evaluated and managed locally. This has the potential to reduce the burden on primary care providers and reduce delays in the diagnosis of common dizziness and vertigo disorders. ACKNOWLEDGMENTS: The primary author acknowledges the significant contributions of the following co-authors: Gary P. Jacobson: conceptualization and design of the investigation, data acquisition, data analysis, authorship of the manuscript, revision of the manuscript, and final approval for submission. Erin G. Piker: conceptualization and design of the investigation, data acquisition, data analysis, authorship of the manuscript, revision of the manuscript, and final approval for submission. Kelsey Hatton: data acquisition, authorship of the manuscript, revision of the manuscript, and final approval for submission. Kenneth E. Watford: design of the investigation, data acquisition, authorship of the manuscript, revision of the manuscript, and final approval for submission. Timothy Trone: data acquisition, authorship of the manuscript, revision of the manuscript, and final approval for submission. Devin L. McCaslin: conceptualization of the study, data acquisition, authorship of the manuscript, revision of the manuscript, and final approval for submission. Marc L. Bennett: data acquisition, authorship of the manuscript, revision of the manuscript, and final approval for submission. Alejandro Rivas: data acquisition, authorship of the manuscript, revision of the manuscript, and final approval for submission. David S. Haynes: data acquisition, authorship of the manuscript, revision of the manuscript, and final approval for submission. Richard A. Roberts: data acquisition, authorship of the manuscript, revision of the manuscript, and final approval for submission. The authors have no conflicts of interest to disclose. Address for correspondence: Gary P. Jacobson, Division of Audiology, Vanderbilt Bill Wilkerson Center, Medical Center East, South Tower, Suite 9302, Nashville, TN 37232. E-mail: gary.jacobson@vanderbilt.edu Received December 19, 2017; accepted May 14, 2018. Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved.

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