Evidence map›Paper›PMID 38247216›Full record

ArticleEuropean journal of neurology2024

A diagnostic framework to identify vestibular involvement in multi-sensory neurological disease.

Amanda J Male, Sarah L Holmes, Nehzat Koohi, Magdalena Dudziec, Michael G Hanna, Gita M Ramdharry, Chiara Pizzamiglio, Robert D S Pitceathly, Diego Kaski

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in European journal of neurology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
0.7field-weighted citation impact, top 31% 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

2 citing papers in PubMed, 3 citations in OpenAlex.

  1. Article
  2. Article
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

9 authors at 2 institutions in 1 country.

Amanda J MaleSENSE Research Unit, Department of Clinical and Movement Neurosciences, Institute of Neurology, University College London, London, UK.ORCID 0000-0001-5508-908X
Sarah L HolmesNHS Highly Specialised Service for Rare Mitochondrial Disorders, Queen Square Centre for Neuromuscular Diseases, The National Hospital for Neurology and Neurosurgery, London, UK.
Nehzat KoohiSENSE Research Unit, Department of Clinical and Movement Neurosciences, Institute of Neurology, University College London, London, UK.
Magdalena DudziecDepartment of Neuromuscular Diseases, UCL Queen Square Institute of Neurology, London, UK.
Michael G HannaNHS Highly Specialised Service for Rare Mitochondrial Disorders, Queen Square Centre for Neuromuscular Diseases, The National Hospital for Neurology and Neurosurgery, London, UK.
Gita M RamdharryDepartment of Neuromuscular Diseases, UCL Queen Square Institute of Neurology, London, UK.
Chiara PizzamiglioNHS Highly Specialised Service for Rare Mitochondrial Disorders, Queen Square Centre for Neuromuscular Diseases, The National Hospital for Neurology and Neurosurgery, London, UK.
Robert D S PitceathlyNHS Highly Specialised Service for Rare Mitochondrial Disorders, Queen Square Centre for Neuromuscular Diseases, The National Hospital for Neurology and Neurosurgery, London, UK.ORCID 0000-0002-6123-4551
Diego KaskiSENSE Research Unit, Department of Clinical and Movement Neurosciences, Institute of Neurology, University College London, London, UK.ORCID 0000-0002-0591-646X
National Hospital for Neurology and Neurosurgery · GBUniversity College London · GB

Funding

Medical Research Council MC_PC_21046Medical Research Council MR/S002065/1
6 · The paper itself

Abstract

background and purposeIdentifying vestibular causes of dizziness and unsteadiness in multi-sensory neurological disease can be challenging, with problems typically attributed to central or peripheral nerve involvement. Acknowledging vestibular dysfunction as part of the presentation provides an opportunity to access targeted vestibular rehabilitation, for which extensive evidence exists. A diagnostic framework was developed and validated to detect vestibular dysfunction, benign paroxysmal positional vertigo or vestibular migraine. The specificity and sensitivity of the diagnostic framework was tested in patients with primary mitochondrial disease.

methodsAdults with a confirmed diagnosis of primary mitochondrial disease were consented, between September 2020 and February 2022. Participants with and without dizziness or unsteadiness underwent remote physiotherapy assessment and had in-person detailed neuro-otological assessment. The six framework question responses were compared against objective neuro-otological assessment or medical notes. The output was binary, with sensitivity and specificity calculated.

resultsSeventy-four adults completed the study: age range 20-81 years (mean 48 years, ±SD 15.05 years); ratio 2:1 female to male. The framework identified a vestibular diagnosis in 35 participants, with seven having two diagnoses. The framework was able to identify vestibular diagnoses in adults with primary mitochondrial disease, with a moderate (40-59) to very high (90-100) sensitivity and positive predictive value, and moderate to high (60-74) to very high (90-100) specificity and negative predictive value.

conclusionsOverall, the clinical framework identified common vestibular diagnoses with a moderate to very high specificity and sensitivity. This presents an opportunity for patients to access effective treatment in a timely manner, to reduce falls and improve quality of life.

Indexed as

Migraine DisordersMitochondrial DiseasesVestibular DiseasesAdultAgedAged, 80 and overBenign Paroxysmal Positional VertigoDizzinessFemaleHumansMaleMiddle AgedQuality of LifeVertigoYoung Adultdiagnosisdizzinessneurotologyvertigo

Identifiers

PMID38247216
PMCPMC11235777
OpenAlexW4391108215

What OpenQuestion holds

Textmetadata
LicenceCC BY
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.