Effectiveness of training on vertigo/dizziness coding in primary care: a community-based cluster-randomized trial

Area of Science:

• Medical Education
• Primary Care Medicine
• Neurology

Background:

• Many vertigo patients receive non-specific diagnoses, leading to delayed treatment and unnecessary investigations.
• Improving diagnostic accuracy in primary care is crucial for effective vertigo management.
• A structured training program was developed to enhance primary care physicians' diagnostic skills for vertigo.

Purpose of the Study:

• To evaluate the effectiveness of an online and face-to-face training program for primary care physicians on diagnosing vertigo.
• To assess the impact of the training on the specificity and accuracy of vertigo diagnoses in primary care settings.

Main Methods:

• A multicenter, cluster-randomized controlled trial was conducted across 20 primary care centers.
• The intervention group received 14 hours of online training plus a face-to-face session on vertigo management.
• Data from 545,938 patients in 2019 and 513,638 in 2022 were analyzed from the SIDIAP database.

Main Results:

• Following the intervention, the overall rate of new vertigo-related diagnoses increased slightly.
• The intervention group showed a statistically significant increase in the use of specific vertigo diagnoses, especially Benign Paroxysmal Positional Vertigo (BPPV).
• Regression models indicated higher odds of specific vertigo diagnoses in the intervention group.

Conclusions:

• A structured training intervention significantly improved diagnostic coding for vertigo in primary care.
• The training fostered more accurate and specific diagnoses, potentially improving patient outcomes.
• This approach enhances the ability of primary care physicians to manage vertigo effectively.