Landon-Lane Renee L, Piker Erin G, Jacobson Gary P, Hatton Kelsey, Roberts Richard A
Divisions of Audiology and Vestibular Sciences, Vanderbilt University Medical Center, Nashville, Tennessee, USA.
Department of Communication Sciences and Disorders, James Madison University, Harrisonburg, Virginia, USA.
Ear Hear. 2021 Jan/Feb;42(1):206-213. doi: 10.1097/AUD.0000000000000918.
This investigation was conducted to measure the test-retest reliability of the Dizziness Symptom Profile (DSP). The DSP was developed to assist primary care providers, general otolaryngologists, and other health care providers in the development of a differential diagnosis for patients who present with dizziness, vertigo, or unsteadiness. The DSP yields a score ranging from 0 to 100% for each of 7 subscales. Each subscale represents a different diagnosis including benign paroxysmal positional vertigo, Ménière's disease, persistent postural-perceptual dizziness (PPPD), superior semi-circular canal dehiscence, vestibular migraine, vestibular neuritis, and general unsteadiness.
Subjects were 150 adult patients (mean age 56.79 years, SD 15.69 years) referred to the Balance Disorders Clinic at Vanderbilt University Medical Center. Subjects completed two administrations of the DSP. The mean interval between test administrations was 1.58 days (SD 1.78 days). The response modes for the DSP were both a 0 to 100 mm visual analog scale (scored 0 mm = "strongly disagree" to 100 mm = "strongly agree") and, by extrapolation, the original 5-point Likert scale where the anchors were "strongly disagree" (scored 0 points) and "strongly agree" (scored 4 points).
Pearson correlation coefficients were calculated to assess test-retest reliability for individual DSP items, and ranged from r = 0.67 to 0.91 (mean 0.80; p < 0.001). Cronbach's α coefficients were calculated to assess internal consistency reliability of items comprising the seven subscales. Each subscale had an acceptable level of internal consistency (Cronbach's α coefficients > 0.7) with the exception of PPPD which approached 0.7. Intraclass correlation coefficient estimates and their 95% confidence intervals were also calculated to assess the relative reliability of the subscales. All 7 subscales showed moderate to strong test-retest reliability, with intraclass correlation coefficients ranging from 0.85 to 0.94. Minimal detectable change (MDC) scores were calculated to assess absolute variability/measurement error for the seven subscale scores (which range from 0 to 100%). MDC values ranged from 16% (PPPD) to 25% (unsteadiness).
(1) The test-retest reliability of the DSP is moderate to strong. (2) MDC values for each subscale were determined. (3) The DSP coupled with the Dizziness Handicap Inventory enables the clinician to evaluate the constructs of dizziness impairment, and disability/handicap. (4) The DSP may help provide a window to the natural history of dizziness disease(s). (5) The DSP provides a less biased assessment of the symptoms reported by the patient.
本研究旨在测量头晕症状量表（DSP）的重测信度。DSP旨在辅助初级保健提供者、普通耳鼻喉科医生及其他医疗保健提供者，为出现头晕、眩晕或不稳症状的患者进行鉴别诊断。DSP的7个分量表各自的得分范围为0至100%。每个分量表代表一种不同的诊断，包括良性阵发性位置性眩晕、梅尼埃病、持续性姿势 - 知觉性头晕（PPPD）、上半规管裂、前庭性偏头痛、前庭神经炎以及一般性不稳。
研究对象为150名成年患者（平均年龄56.79岁，标准差15.69岁），他们被转诊至范德比尔特大学医学中心的平衡障碍诊所。研究对象完成了两次DSP测评。两次测评之间的平均间隔时间为1.58天（标准差1.78天）。DSP的反应方式包括一个0至100毫米的视觉模拟量表（评分0毫米 = “强烈不同意”至100毫米 = “强烈同意”），通过外推法，还有原始的5点李克特量表，其锚定为“强烈不同意”（评分为0分）和“强烈同意”（评分为4分）。
计算了Pearson相关系数以评估DSP各个项目的重测信度，范围为r = 0.67至0.91（平均0.80；p < 0.001）。计算了Cronbach's α系数以评估构成7个分量表的项目的内部一致性信度。除PPPD接近0.7外，每个分量表都具有可接受的内部一致性水平（Cronbach's α系数 > 0.7）。还计算了组内相关系数估计值及其95%置信区间，以评估分量表的相对信度。所有7个分量表均显示出中度至高度的重测信度，组内相关系数范围为0.85至0.94。计算了最小可检测变化（MDC）分数，以评估7个分量表分数（范围为0至100%）的绝对变异性/测量误差。MDC值范围为16%（PPPD）至25%（不稳）。
（1）DSP的重测信度为中度至高度。（2）确定了每个分量表的MDC值。（3）DSP与头晕残障量表相结合，使临床医生能够评估头晕损伤、残疾/残障的构成。（4）DSP可能有助于为头晕疾病自然史提供一个窗口。（5）DSP对患者报告的症状提供了偏差较小的评估。
