Balance Disorders Unit, Nofer Institute of Occupational Medicine, 91-348 Lodz, Poland.
Nofer Institute of Occupational Medicine, 91-348 Lodz, Poland.
Int J Environ Res Public Health. 2021 Feb 24;18(5):2210. doi: 10.3390/ijerph18052210.
(1) Objectives: The evaluation of dizzy patients is difficult due to nonspecific symptoms that require a multi-specialist approach. The Dizziness Handicap Inventory (DHI) is widely used in the assessment of dizziness-related disability, but its clinical efficacy needs further expansion. The aim of this study was to identify the subscales of DHI that may correlate with some vestibular or nonvestibular dysfunctions. (2) Material and methods: This observational study included 343 dizzy patients with one of the following clinical conditions: Vestibular impairment noncompensated or compensated, central or bilateral, benign paroxysmal positional vertigo (BPPV), migraine and psychogenic dizziness. Principal component analysis was used to examine the factorial structure of the questionnaire. (3) Results: The DHI questionnaire total scoring and its vestibular subscale distinguished between patients with compensated and uncompensated vestibular dysfunction with positive predictive values of 76% and 79%, respectively. The DHI items composing the F3 (positional) subscale revealed the highest scoring in the BPPV group with 75% sensitivity and 92% negative predictive value (NPV) in reference to Dix-Hallpike tests. The DHI total score and the subscales scores correlated with anxiety-depression, and the highest correlation coefficients were calculated for vestibular (F2 0.56) and anxiety (F5 0.51) subscales. (4) Conclusions: Our analysis revealed that the DHI vestibular subscale distinguishes between patients with compensated and uncompensated vestibular dysfunction. The positional subscale showed the highest scoring in the BPPV group with high sensitivity and low specificity of the test. The DHI is highly correlated with patients' psychological status.
(1) 目的：由于头晕患者的症状不具特异性，需要多学科的方法进行评估，因此对其进行评估较为困难。眩晕障碍量表（DHI）广泛用于评估与头晕相关的残疾，但需要进一步扩展其临床疗效。本研究旨在确定 DHI 的亚量表，这些亚量表可能与某些前庭或非前庭功能障碍相关。(2) 材料和方法：本观察性研究纳入了 343 例头晕患者，他们的临床情况如下：前庭功能障碍未代偿或代偿、中枢或双侧、良性阵发性位置性眩晕（BPPV）、偏头痛和精神性头晕。采用主成分分析来检验问卷的因子结构。(3) 结果：DHI 问卷总评分及其前庭亚量表可区分代偿性和非代偿性前庭功能障碍患者，阳性预测值分别为 76%和 79%。组成 F3（位置性）亚量表的 DHI 项目在 BPPV 组中得分最高，Dix-Hallpike 试验的敏感性为 75%，阴性预测值（NPV）为 92%。DHI 总评分和各亚量表评分与焦虑抑郁相关，其中前庭（F2，0.56）和焦虑（F5，0.51）亚量表的相关系数最高。(4) 结论：我们的分析表明，DHI 前庭亚量表可区分代偿性和非代偿性前庭功能障碍患者。位置性亚量表在 BPPV 组中的得分最高，该测试具有较高的敏感性和较低的特异性。DHI 与患者的心理状态高度相关。
