(535) Validation of Symptom-Based Benign Paroxysmal Positional Vertigo Questionnaire

Introduction: The American Academy of Otolaryngology-Head and Neck Surgery has published clinical guidelines for the diagnosis and treatment of Benign Paroxysmal Positional Vertigo (BPPV), which include the recommendation against the use of vestibular testing. Despite these recommendations, many patients continue to receive comprehensive testing because implementing evidence-based triage remains a challenge. In 2020, Kim et al. reported on a symptoms-based BPPV questionnaire and noted excellent sensitivity and specificity. The purpose of this study was to validate a translated version of the self-administered symptom-based BPPV questionnaire by examining diagnostic accuracy in detection of BPPV.

Methods: A retrospective chart review of 477 patients evaluated in a tertiary care vestibular clinic between January 1, 2021 to April 28, 2022 was performed. Patients completed the 6-item questionnaire without provider assistance or instruction and underwent full vestibular testing. Descriptive statistics were performed to summarize the characteristics of the cohort and clinical encounters. Diagnostic accuracy was assessed.

Results: The mean age of the cohort was 56.2 years (standard deviation of 17.2) and a majority (63.3%) was female (302/477) and white (69.8%, 333/477). Using gold standard positioning techniques (Dix-Hallpike and supine roll test), 69 (14.5%) patients were diagnosed as having BPPV. Examining the self-report responses of the questionnaire, the sensitivity was found to be 63.8% and specificity was 74.3%. The positive predictive value was found to be 29.5% and the negative predictive value 92.4%.

Conclusions: Although our sensitivity and specificity were slightly poorer than those reported by Kim et al., the translated self-administered questionnaire still demonstrated reasonable and promising diagnostic accuracy. This measure may be useful to help identify likely cases of BPPV for clinical triage. Additional research is needed to determine implementation strategy and cost-effectiveness of such a triage system in practice.