Evidence map›Paper›PMID 34398269›Full record

Observational studyJournal of neurology2022

Capturing vertigo in the emergency room: three tools to double the rate of diagnosis.

Benjamin Nham, Nicole Reid, Kendall Bein, Andrew P Bradshaw, Leigh A McGarvie, Emma C Argaet, Allison S Young, Shaun R Watson, G Michael Halmagyi, Deborah A Black and 1 more

Abstract readObservational Study
PubMed Publisher
In one paragraph

Observational study in Journal of neurology, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 27 papers, 4 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
27citing papers in PubMed, 4 pooled it
3.0field-weighted citation impact, top 8% of its field
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

27 citing papers in PubMed, 4 syntheses or guidelines pooled it, 46 citations in OpenAlex.

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  7. A digital neurotology history: Characteristics and inter-rater reliability.European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery · 2026
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  17. Neurological update: neuro-otology 2023.Journal of neurology · 2023
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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

11 authors at 2 institutions in 1 country.

Benjamin NhamInstitute of Clinical Neurosciences, Central Clinical School, Royal Prince Alfred Hospital, University of Sydney, Sydney, NSW, Australia.
Nicole ReidInstitute of Clinical Neurosciences, Central Clinical School, Royal Prince Alfred Hospital, University of Sydney, Sydney, NSW, Australia.
Kendall BeinCentral Clinical School, University of Sydney, Sydney, NSW, Australia.
Andrew P BradshawInstitute of Clinical Neurosciences, Central Clinical School, Royal Prince Alfred Hospital, University of Sydney, Sydney, NSW, Australia.
Leigh A McGarvieInstitute of Clinical Neurosciences, Central Clinical School, Royal Prince Alfred Hospital, University of Sydney, Sydney, NSW, Australia.
Emma C ArgaetCentral Clinical School, University of Sydney, Sydney, NSW, Australia.
Allison S YoungCentral Clinical School, University of Sydney, Sydney, NSW, Australia.
Shaun R WatsonPrince of Wales Clinical School, University of New South Wales, Sydney, NSW, Australia.
G Michael HalmagyiInstitute of Clinical Neurosciences, Central Clinical School, Royal Prince Alfred Hospital, University of Sydney, Sydney, NSW, Australia.
Deborah A BlackFaculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia.
Miriam S WelgampolaInstitute of Clinical Neurosciences, Central Clinical School, Royal Prince Alfred Hospital, University of Sydney, Sydney, NSW, Australia. miriam@icn.usyd.edu.au.ORCID http://orcid.org/0000-0002-4573-4740
The University of Sydney · AUUNSW Sydney · AU

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveMany patients attending the emergency room (ER) with vertigo, leave without a diagnosis. We assessed whether the three tools could improve ER diagnosis of vertigo.

methodsA prospective observational study was undertaken on 539 patients presenting to ER with vertigo. We used three tools: a structured-history and examination, nystagmus video-oculography (VOG) in all patients, additional video head-impulse testing (vHIT) for acute-vestibular-syndrome (AVS).

resultsIn the intervention-group (n = 424), case-history classified AVS in 34.9%, episodic spontaneous-vertigo (ESV 32.1%), and episodic positional-vertigo (EPV 22.6%). In AVS, we employed "Quantitative-HINTS plus" (Head-Impulse, Nystagmus and Test-of-Skew quantified by vHIT and VOG, audiometry) to identify vestibular-neuritis (VN) and stroke (41.2 and 31.1%). vHIT gain ≤ 0.72, catch-up saccade amplitude > 1.4

conclusionThree tools: a structured-assessment, vHIT and VOG doubled the rate of diagnosis in the ER.

Indexed as

Meniere DiseaseNystagmus, PathologicVestibular NeuronitisBenign Paroxysmal Positional VertigoEmergency Service, HospitalHead Impulse TestHumansAll cerebrovascular disease/strokeDiagnostic test assessmentHINTSNystagmusVertigo

Identifiers

PMID34398269
OpenAlexW3195746294

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

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.