Effectiveness of a structured questionnaire for diagnosis of Menière's disease in the first visit

A structured questionnaire of vertigo (SQV) was used to search patients with Menière's disease (MD) in the first visit. One-hundred consecutive outpatients that complained of dizziness or vertigo were studied. Diagnosis of MD was accepted if three investigators independently recorded it among a list of 29 diagnostic categories after reviewing the SQV. The AAO criteria for definite MD defined by the Committee on Hearing and Equilibrium after 10 months or more of follow-up were the gold standard to contrast questionnaire-based diagnosis. Seven patients were considered as MD with the SQV. The sensitivity (Sn), specificity (Sp) and positive predictive value of the SQV for definite MD were 80%, 97% and 57% respectively, being the false positive rate 3%. The probability for diagnosis of definite MD using the SQV in the first visit was 58% in a set up with a 5% of prevalence. The best predictor selected by all investigators was the presence of hearing loss (Sn 100%, Sp 85%, positive likelihood ratio 6.67). Because of the high specificity, the SQV of vertigo results a useful test to advance the diagnosis of definite MD.