Can emergency physicians accurately and reliably assess acute vertigo in the emergency department?

Emergency Medicine Australasia : EMA
Simone VanniStefano Grifoni

Abstract

To validate a clinical diagnostic tool, used by emergency physicians (EPs), to diagnose the central cause of patients presenting with vertigo, and to determine interrater reliability of this tool. A convenience sample of adult patients presenting to a single academic ED with isolated vertigo (i.e. vertigo without other neurological deficits) was prospectively evaluated with STANDING (SponTAneousNystagmus, Direction, head Impulse test, standiNG) by five trained EPs. The first step focused on the presence of spontaneous nystagmus, the second on the direction of nystagmus, the third on head impulse test and the fourth on gait. The local standard practice, senior audiologist evaluation corroborated by neuroimaging when deemed appropriate, was considered the reference standard. Sensitivity and specificity of STANDING were calculated. On the first 30 patients, inter-observer agreement among EPs was also assessed. Five EPs with limited experience in nystagmus assessment volunteered to participate in the present study enrolling 98 patients. Their average evaluation time was 9.9 ± 2.8 min (range 6-17). Central acute vertigo was suspected in 16 (16.3%) patients. There were 13 true positives, three false positives, 81 true negatives and o...Continue Reading

References

Jun 1, 1989·Annals of Emergency Medicine·R D HerrJ J Mathews
Jul 1, 1996·Neurology·C R GomezC M Burch
Nov 25, 2003·European Neurology·Thierry MoulinLucien Rumbach
Sep 2, 2006·Stroke; a Journal of Cerebral Circulation·Kevin A KerberLewis B Morgenstern
Jan 12, 2007·Current Opinion in Neurology·Hannelore K Neuhauser
Jul 22, 2008·Academic Emergency Medicine : Official Journal of the Society for Academic Emergency Medicine·Kevin A KerberA Mark Fendrick
Oct 14, 2008·Lancet Neurology·Jonathan A EdlowSean I Savitz
Dec 5, 2008·Otolaryngology--head and Neck Surgery : Official Journal of American Academy of Otolaryngology-Head and Neck Surgery·Neil BhattacharyyaUNKNOWN American Academy of Otolaryngology-Head and Neck Surgery Foundation
Feb 17, 2009·Emergency Medicine Clinics of North America·Kevin A Kerber
Oct 6, 2009·Academic Emergency Medicine : Official Journal of the Society for Academic Emergency Medicine·David E Newman-TokerJonathan A Edlow
Oct 7, 2009·Neurology·Jungmoo NamJi Soo Kim
Nov 7, 2009·Journal of Vestibular Research : Equilibrium & Orientation·Alexandre BisdorffDavid E Newman-Toker
Oct 16, 2010·Cerebrovascular Diseases·Regina SchlaegerThomas Baumann
May 18, 2011·CMAJ : Canadian Medical Association Journal = Journal De L'Association Medicale Canadienne·Alexander A TarnutzerDavid E Newman-Toker
Jun 17, 2011·Academic Emergency Medicine : Official Journal of the Society for Academic Emergency Medicine·Kevin A KerberDavid E Newman-Toker
Mar 24, 2012·Stroke; a Journal of Cerebral Circulation·Babak B NaviAnthony S Kim
Oct 17, 2013·Academic Emergency Medicine : Official Journal of the Society for Academic Emergency Medicine·David E Newman-TokerJorge C Kattah
Jun 13, 2014·Neurology·Ali S Saber TehraniDavid E Newman-Toker

❮ Previous
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Citations

Feb 21, 2016·The Journal of Emergency Medicine·Jonathan A Edlow, David Newman-Toker
Aug 2, 2015·Neurologic Clinics·David E Newman-Toker, Jonathan A Edlow
Oct 16, 2016·Emergency Medicine Clinics of North America·Jonathan A Edlow
Sep 22, 2016·Internal and Emergency Medicine·Simone VanniPietro Amedeo Modesti
Apr 22, 2017·Nature Reviews. Neurology·Thomas Brandt, Marianne Dieterich
Feb 21, 2018·Stroke; a Journal of Cerebral Circulation·Ali S Saber TehraniDavid E Newman-Toker
Oct 1, 2020·The Journal of International Medical Research·Ming-Ta TsaiFu-Jen Cheng
Jun 20, 2017·Journal of Neurologic Physical Therapy : JNPT·Michael C SchubertSusan L Whitney
Apr 6, 2018·Clinical and Experimental Emergency Medicine·Alexander Cuculiza Henriksen, Peter Hallas
Mar 13, 2019·Journal of Otolaryngology - Head & Neck Surgery = Le Journal D'oto-rhino-laryngologie Et De Chirurgie Cervico-faciale·Phillip StaibanoDarren Tse
Nov 11, 2020·Academic Emergency Medicine : Official Journal of the Society for Academic Emergency Medicine·Cait DmitriewRobert Ohle
Jul 11, 2021·Academic Emergency Medicine : Official Journal of the Society for Academic Emergency Medicine·Camille GerlierOlivier Ganansia
Aug 3, 2021·Frontiers in Neurology·Carolin Hoyer, Kristina Szabo
Aug 11, 2021·Otolaryngology--head and Neck Surgery : Official Journal of American Academy of Otolaryngology-Head and Neck Surgery·Giovanni LampasonaMatthew G Crowson

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