Identifying tests to evaluate in a diagnostic accuracy study for patients with vertigo in general practice: a Delphi...

Area of Science:

• Neurology
• Otolaryngology
• General Practice

Background:

• Vertigo significantly impacts patient quality of life, with most cases initially managed by general practitioners (GPs).
• Current diagnostic tools for GPs are limited due to a lack of diagnostic accuracy studies in general practice settings.
• This study addresses the need for evidence-based diagnostic approaches for vertigo in primary care.

Purpose of the Study:

• To determine essential diagnostic tests for vertigo that warrant investigation in a diagnostic accuracy study.
• To establish a consensus among international experts on the most relevant diagnostic tests for vertigo in general practice.

Main Methods:

• An online Delphi procedure was employed, involving 20 national and international experts (otolaryngologists, neurologists, GPs).
• Experts evaluated 46 diagnostic tests based on existing guidelines and systematic reviews, with provisions for suggesting additional tests.
• Consensus (≥70%) was required for test inclusion or exclusion, with data analyzed using descriptive and content analysis.

Main Results:

• A panel of 20 international experts reached consensus on 17 diagnostic tests for vertigo.
• Of the 17 tests, 15 are supported by the Dutch GP guideline, with the Tandem walking test and Romberg test also included.
• The Delphi procedure involved multiple rounds with a 100% response rate, leading to the inclusion and exclusion of specific tests.

Conclusions:

• An international expert panel achieved consensus on 17 key diagnostic tests for vertigo in general practice.
• These 17 tests are recommended for further investigation in diagnostic accuracy studies.
• The findings aim to enhance the diagnostic capabilities of general practitioners when managing patients with vertigo.