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Usefulness of Exam Questions and Vital Signs for Predicting the Outcome of Objective Vestibular Tests
Author(s) -
Cohen Helen S.,
SangiHaghpeykar Haleh,
Watts Megan,
Sweeney Alex D.,
Peng Angela S.
Publication year - 2021
Publication title -
the laryngoscope
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.181
H-Index - 148
eISSN - 1531-4995
pISSN - 0023-852X
DOI - 10.1002/lary.29487
Subject(s) - medicine , vertigo , lightheadedness , blood pressure , medical record , vestibular system , physical therapy , gold standard (test) , pediatrics , surgery , audiology
Objectives/Hypothesis To determine the value of standard clinic screening questions and vital signs in predicting abnormal vestibular function, indicated by standard objective diagnostic tests. Study Design Retrospective records review. Methods We reviewed electronic medical records of 150 patients seen by the neurotologists or the physician assistant they supervised, in an out‐patient tertiary care clinic, between June 2018 and March 2020, and subsequently referred for the complete objective vestibular test battery (VB). Results Of standard questions asked during the initial exam about vertigo, disequilibrium, lightheadedness and oscillopsia, only vertigo predicted an abnormal response on the VB. More males than females had abnormal VB responses, P < .05. Pulse was not related to VB score. Significantly more subjects with blood pressure in the range for stage 2 hypertension (blood pressure [BP] stage 2) had abnormal than normal results on the VB, P < .00001. Subjects with BP stage 2 had high rates of diabetes (34.2%) and hypertension (68.4%) as diagnosed by their primary care physicians or cardiologists. Conclusion Complaints of subjective vertigo and BP in the range of hypertension stage 2 are most likely to predict abnormal findings on the VB. Therefore, during an examination of a patient who comes in complaining of dizziness, two measures may be the most useful for screening: BP in the range of hypertension type 2, when BP is taken by a nurse, and a question to determine whether or not the patient has true vertigo. Level of Evidence 3 Laryngoscope , 131:1382–1385, 2021