Validation of a comprehensive diagnostic algorithm for patients with acute vertigo and dizziness

Area of Science:

• Neurology
• Otolaryngology
• Emergency Medicine

Background:

• Vertigo and dizziness are frequent emergency department complaints with complex differential diagnoses.
• Existing diagnostic algorithms often focus narrowly on cerebrovascular events (CVEs) or specific vestibular disorders.
• A comprehensive approach is needed to address the diagnostic challenges of acute vertigo and dizziness.

Purpose of the Study:

• To develop and validate a comprehensive diagnostic algorithm for identifying patients with CVEs.
• To classify the most common non-vascular vestibular disorders.
• To create a tool applicable beyond specific patient subgroups in clinical settings.

Main Methods:

• A three-level diagnostic algorithm was created based on international guidelines and evidence.
• The algorithm addresses both CVE detection and classification of six common vestibular disorders.
• Validation was performed on a prospectively collected dataset of 407 emergency department patients.

Main Results:

• The algorithm achieved an overall accuracy of 71% (287/407 patients).
• Cerebrovascular events (CVEs) were identified with high sensitivity (94%).
• Six common vestibular disorders were classified with high specificity (>95%).

Conclusions:

• The developed diagnostic algorithm effectively classifies common vestibular disorders and identifies CVEs.
• The algorithm integrates key questions and clinical examinations for comprehensive diagnosis.
• Its broad applicability makes it suitable for diverse clinical settings, including primary care.