ArticleFrontiers in neurology
Unnecessary magnetic resonance imaging is associated with diagnostic delay and financial burden in benign paroxysmal positional vertigo: a retrospective study in Mongolia.
Article in Frontiers in neurology. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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9 authors.
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Abstract
Introduction: This single-center, retrospective cohort study investigated the clinical characteristics, diagnostic pathways, and economic burden of benign paroxysmal positional vertigo (BPPV) at a national tertiary referral ENT hospital in Ulaanbaatar, Mongolia. Methods: We analyzed 162 patients (mean age, 50.0 ± 11.7 years) with confirmed BPPV who completed follow-up between January 2019 and January 2021. Patients were treated with canalith repositioning procedures and instructed to perform self-maneuvers. The primary outcome was symptom resolution at 7, 14, and 28 days, and the secondary outcome was the change in Dizziness Handicap Inventory (DHI) scores. Results: Results showed that 102 patients (62.5%) were referred from other hospitals, yet only 6 (3.7%) were correctly diagnosed prior to referral. Multivariate logistic regression identified no specific clinical symptoms predicting magnetic resonance imaging (MRI) usage, suggesting that neuroimaging was largely driven by patient-initiated demand in the private sector. The mean diagnostic delay was significantly longer in the MRI group (24.4 ± 19.5 days) compared to the non-MRI group (7.5 ± 5.9 days, Discussion: BPPV patients in Mongolia face significant diagnostic delays and high misdiagnosis rates. While standardized maneuvers are effective, the reliance on costly imaging highlights an urgent need for educational initiatives to improve awareness and primary care triage in developing countries.
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