Evidence map›Paper›PMID 32867677›Full record

ArticleBMC emergency medicine2020

Characteristics and resource needs in patients with vestibular symptoms: a comparison of patients with symptoms of unknown versus determined origin.

Martin Müller, Martina B Goeldlin, Janika Gaschen, Thomas C Sauter, Stephanie Stock, Franca Wagner, Aristomenis K Exadaktylos, Urs Fischer, Roger Kalla, Georgios Mantokoudis

Abstract readComparative Study
In one paragraph

Article in BMC emergency medicine, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Martin MüllerDepartment of Emergency Medicine, Inselspital, University Hospital Bern, University of Bern, Bern, Switzerland.
Martina B GoeldlinDepartment of Neurology, Inselspital, University Hospital Bern, University of Bern, Freiburgstrasse, 3010, Bern, Switzerland. martinabeatrice.goeldlin@insel.ch.ORCID 0000-0001-5800-116X
Janika GaschenDepartment of Neurology, Inselspital, University Hospital Bern, University of Bern, Freiburgstrasse, 3010, Bern, Switzerland.
Thomas C SauterDepartment of Emergency Medicine, Inselspital, University Hospital Bern, University of Bern, Bern, Switzerland.
Stephanie StockInstitute of Health Economics and Clinical Epidemiology, Cologne University Hospital, Cologne, Germany.
Franca WagnerUniversity Institute of Diagnostic and Interventional Neuroradiology, Inselspital, University Hospital Bern, University of Bern, Bern, Switzerland.
Aristomenis K ExadaktylosDepartment of Emergency Medicine, Inselspital, University Hospital Bern, University of Bern, Bern, Switzerland.
Urs FischerInstitute of Health Economics and Clinical Epidemiology, Cologne University Hospital, Cologne, Germany.
Roger KallaInstitute of Health Economics and Clinical Epidemiology, Cologne University Hospital, Cologne, Germany.
Georgios MantokoudisDepartment of Otorhinolaryngology, Head and Neck Surgery, Inselspital, University Hospital Bern, University of Bern, Bern, Switzerland.

Funding

Schweizerische Akademie der Medizinischen Wissenschaften 14/17Schweizerische Akademie der Medizinischen Wissenschaften YTCR 13/18Schweizerischer Nationalfonds zur Förderung der Wissenschaftlichen Forschung 320030_173081
6 · The paper itself

Abstract

backgroundVestibular symptoms are a frequent reason for presenting at the emergency department (ED). Underlying conditions range in severity from life-threatening to benign, but often remain undiagnosed despite extensive investigations. We aimed to identify clinical characteristics that are associated with ED consultations by patients with vestibular symptoms of unknown origin (VUO) and to quantify the ED resources consumed during the investigations.

methodsThis retrospective one-year, single-centre, cross-sectional study assessed ED consultations with patients whose chief complaint was 'vestibular symptoms'. Data on risk factors, clinical characteristics, management and ED resources were extracted from the administrative database and medical records. Consultations were grouped according to the discharge diagnosis as either VUO or non-VUO. We determined clinical factors associated with VUO and compared ED resource consumption by the two patient groups using multivariable analysis.

resultsA total of 1599 ED consultations were eligible. Of these, 14.3% (n = 229) were consultations with patients with VUO. Clinical characteristics included in the final multivariable model to determine associations with VUO were sensory disorders, aural fullness, improvement at rest, absence of situational provocation, pre-existing neurological conditions, and age < 65 years. Patients with VUO had higher total ED resource consumption in terms of physicians' work and radiology resources, as a result of more use of computed tomography and magnetic resonance imaging.

conclusionOne in seven emergency patients with vestibular symptoms is dismissed without a diagnosis. Clinical characteristics of VUO patients are distinct from patients in whom a diagnosis was made in the ED. VUO triggers higher ED resource consumption, which can be justified if appropriately indicated.

Indexed as

Emergency Service, HospitalHealth Services Needs and DemandAdultAgedCross-Sectional StudiesDiagnosis, DifferentialDiagnostic ImagingDizzinessFemaleHumansMaleMiddle AgedParesthesiaRetrospective StudiesRisk FactorsSwitzerlandDizzinessEmergency departmentHealth resourcesResource allocationVertigoVestibular

Identifiers

PMID32867677
PMCPMC7460761

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.