ReviewAudiology research2023
Bedside Testing in Acute Vestibular Syndrome-Evaluating HINTS Plus and Beyond-A Critical Review.
Review in Audiology research, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers, 4 of them syntheses that pooled it.
What it found
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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.
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.
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Who cites it
21 citing papers in PubMed, 4 syntheses or guidelines pooled it.
- The Epidemiology and Clinical Presentation of the Acute Imbalance Syndrome (AIS)-A Systematic Review and Meta-Analysis.European journal of neurology · 2026Pooled it
- The epidemiology and clinical presentation of acute vestibular syndromes: a systematic review of the literature.Journal of neurology · 2026Pooled it
- HINTS+ to diagnose AICA stroke: systematic review of the diagnostic impact of acute unilateral hearing loss in the acute vestibular syndrome.Journal of neurology · 2026Pooled it
- Systematic Review and Meta-Analysis of the Diagnostic Accuracy of a Graded Gait and Truncal Instability Rating in Acutely Dizzy and Ataxic Patients.Cerebellum (London, England) · 2024Pooled it
- A Guide to Patients with Acute Transient Vestibular Symptoms in the Emergency Department.Brain sciences · 2026Review
- Acute vertigo: stroke or not?Current opinion in neurology · 2026Review
- Article
- Diagnostic challenges in posterior circulation ischemic stroke presenting with acute dizziness and vertigo.Frontiers in neurology · 2026Review
- Diagnostic spectrum of unplanned acute hospital admissions within 30 days after emergency department presentation for vertigo in older adults: a province-wide retrospective cohort study.Frontiers in medicine · 2026Article
- Review
- Oculomotor Abnormalities and Nystagmus in Brainstem Disease: A Mini Review.Audiology research · 2025Review
- Accuracy of First-Line Tests for Posterior Circulation Stroke in the Emergency Department: A Scoping Review.Cureus · 2025Review
- Integrated diagnostic algorithm for acute vertigo combining TiTrATE, STANDING, and HINTS: a validation study in the emergency department.Scientific reports · 2025Article
- Review
- Editorial: Stroke and balance disorders.Frontiers in stroke · 2025Article
- R-cVR, a two-step bedside algorithm for the differential diagnosis of acute dizziness and vertigo.Heliyon · 2024Article
- Application of a Video Head Impulse Test in the Diagnosis of Vestibular Neuritis.Life (Basel, Switzerland) · 2024Review
- Diagnosing Emergencies in Undifferentiated Acute Vertigo.Indian journal of otolaryngology and head and neck surgery : official publication of the Association of Otolaryngologists of India · 2024Article
- Feasibility of video-based real-time nystagmus tracking: a lightweight deep learning model approach using ocular object segmentation.Frontiers in neurology · 2024Article
- A preliminary clinical study related to vestibular migraine and cognitive dysfunction.Frontiers in human neuroscience · 2024Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
2 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Acute vertigo and dizziness are frequent presenting symptoms in patients in the emergency department. These symptoms, which can be subtle and transient, present diagnostic challenges because they can be caused by a broad range of conditions that cut across many specialties and organ systems. Previous work has emphasized the value of combining structured history taking and a targeted examination focusing on subtle oculomotor signs. In this review, we discuss various diagnostic bedside algorithms proposed for the acutely dizzy patient. We analyzed these different approaches by calculating their area-under-the-curve (ROC) characteristics and sensitivity/specificity. We found that the algorithms that incorporated structured history taking and the use of subtle oculomotor signs had the highest diagnostic accuracy. In fact, both the HINTS+ bedside exam and the STANDING algorithm can more accurately diagnose acute strokes than early (<24 to 48 h after symptom onset) MRI with diffusion-weighted imaging (DWI). An important caveat is that HINTS and STANDING require moderate training to achieve this accuracy. Therefore, for physicians who have not undergone adequate training, other approaches are needed. These other approaches (e.g., ABCD2 score, PCI score, and TriAGe+ score) rely on vascular risk factors, clinical symptoms, and focal neurologic findings. While these other scores are easier for frontline providers to use, their diagnostic accuracy is far lower than HINTS+ or STANDING. Therefore, a focus on providing dedicated training in HINTS+ or STANDING techniques to frontline clinicians will be key to improving diagnostic accuracy and avoiding unnecessary brain imaging.
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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.