ACR Appropriateness Criteria® Dizziness and Ataxia: 2023 Update.

Area of Science:

• Neurology
• Radiology
• Diagnostic Imaging

Background:

• Dizziness and vertigo evaluation is complex due to non-standardized terms and subjective patient experiences.
• Dizziness can be categorized into vertigo, disequilibrium, presyncope, or lightheadedness, complicating diagnosis.
• Current diagnostic approaches focus on timing, triggers, and associated symptoms, yet imaging selection remains challenging.

Purpose of the Study:

• To provide a framework for selecting appropriate diagnostic imaging for patients with dizziness or vertigo.
• To aid healthcare providers in navigating the complexities of dizziness and vertigo diagnosis.
• To establish evidence-based guidelines for imaging in dizziness and vertigo.

Main Methods:

• Utilizing the American College of Radiology Appropriateness Criteria framework.
• Systematic analysis of peer-reviewed medical literature.
• Adaptation of established methodologies like Grading of Recommendations Assessment, Development, and Evaluation (GRADE).

Main Results:

• The document proposes a framework based on definable clinical variants to guide imaging selection.
• It addresses the lack of standardized nomenclature and subjective symptom reporting.
• Expert opinion serves as an evidentiary source when literature is limited.

Conclusions:

• A structured approach using clinical variants can improve the selection of diagnostic imaging for dizziness and vertigo.
• Standardized criteria are needed to enhance diagnostic accuracy and treatment planning.
• This guideline aims to optimize the use of diagnostic imaging in patients with these symptoms.