Diagnostic indices for vertiginous diseases

Background: Vertigo and dizziness are symptoms which are reported
frequently in clinical practice. We aimed to develop diagnostic
indices for four prevalent vertiginous diseases: benign paroxysmal
positional vertigo (BPPV), Meniere's disease (MD), vestibular
migraine (VM), and phobic postural vertigo (PPV). Methods: Based on
a detailed questionnaire handed out to consecutive patients
presenting for the first time in our dizziness clinic we
preselected a set of seven questions with desirable diagnostic
properties when compared with the final diagnosis after medical
workup. Using exact logistic regression analysis diagnostic scores,
each comprising of four to six items that can simply be added up,
were built for each of the four diagnoses. Results: Of 193 patients
131 questionnaires were left after excluding those with missing
consent or data. Applying the suggested cut-off points, sensitivity
and specificity were 87.5 and 93.5% for BPPV, 100 and 87.4% for MD,
92.3 and 83.7% for VM, 73.7 and 84.1% for PPV, respectively. By
changing the cut-off points sensitivity and specificity can be
adjusted to meet diagnostic needs. Conclusions: The diagnostic
indices showed promising diagnostic properties. Once further
validated, they could provide an ease to use and yet flexible tool
for screening vertigo in clinical practice and epidemiological
research.