Department of Hearing and Speech Sciences, Division of Vestibular Sciences, Vanderbilt University School of Medicine, Nashville, Tennessee, USA.
Department of Communication Sciences and Disorders, James Madison University, Harrisonburg, Virginia, USA.
Ear Hear. 2019 May/Jun;40(3):568-576. doi: 10.1097/AUD.0000000000000628.
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.
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.
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).
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.
头晕、眩晕和不稳是向初级保健提供者就诊的患者常见的主诉。这些患者通常被转诊到耳鼻喉科进行评估和管理。不幸的是，能够管理这些患者的专家数量很少。然而，如果能正确识别，有几种头晕障碍可以由初级保健提供者成功管理。为了帮助识别几种最常见的头晕障碍，我们开发了头晕症状特征（DSP）。DSP 是一种自我报告问卷，旨在生成一个或多个鉴别诊断，可以与患者的病史和体格检查相结合。
本报告描述了三项研究。研究 1 和 2（即探索性和验证性研究，N=514）描述了 DSP 的开发。研究 3（N=195）是一项验证性研究，描述了患者完成的 DSP 与耳鼻喉专家的鉴别诊断之间的一致性程度。
DSP 的最终版本由 31 个项目组成。初步结果表明，DSP 与耳科专家对梅尼埃病（100%一致性）、前庭性偏头痛（95%一致性）和良性阵发性位置性眩晕（82%一致性）的鉴别诊断一致。
初步结果表明，DSP 可能有助于为头晕患者制定鉴别诊断，这些诊断可以在当地进行评估和管理。这有可能减轻初级保健提供者的负担，并减少常见头晕和眩晕障碍的诊断延误。
