A Systematic Review of Clinical Vestibular Symptom Triage, Tools, and Algorithms

Area of Science:

• Otolaryngology
• Neurology
• Diagnostic Medicine

Background:

• Peripheral vestibular disorders present diagnostic challenges in clinical practice, especially for less experienced clinicians.
• Accurate and efficient evaluation tools are crucial for timely diagnosis and management.

Purpose of the Study:

• To systematically evaluate the design, approaches, and outcomes of clinical vestibular symptom triage and decision support tools.
• To identify and categorize contemporary tools reported in published literature.

Main Methods:

• A comprehensive literature search was conducted in August 2020 across MEDLINE, CINAHL, and EMBASE.
• Included search terms related to diagnostic algorithms, protocols, questionnaires, and vestibular disorders.
• Study characteristics, tool metrics, and performance were extracted and assessed using a modified QUADAS-2 tool.

Main Results:

• Eighteen articles reporting novel tools for vestibular disorder evaluation were identified.
• Tools were categorized into self-administered questionnaires, clinician-administered tools, and decision support systems.
• Most tools reported metrics such as sensitivity, specificity, and accuracy for differentiating vestibular pathologies.

Conclusions:

• A variety of tools exist to assist in evaluating patients with vertigo and other vestibular symptoms.
• The current systematic review identified several tools with limited reported evidence for their clinical utility.
• Further high-quality research is needed to validate these diagnostic aids for peripheral vestibular disorders.