How Do Patients and Otolaryngologists Define Dizziness?

Monday, October 2, 2023

2:39 PM - 2:45 PM East Coast USA Time

Location: 101AB

Presenting Author(s)

Brianna L. Murphy, MD

Resident
Walter Reed National Military Medical Center
Rockville, MD, United States

Co-Author(s)

Jakob L. Fischer, MD

Comprehensive Otolaryngologist
Dept. of Otolaryngology - Head & Neck Surgery, Walter Reed National Military Medical Center
Gaithersburg, MD, United States
AT

Anthony M. Tolisano, MD

Associate Program Director
Department of Otolaryngology-Head & Neck Surgery, Walter Reed National Military Medical Center, Bethesda, Maryland
Bethesda, Maryland, United States
Alvaro I. Navarro, MD

Resident Physician
Tulane University
New Orleans, LA, United States
Charles A. Riley, MD

Chief
Walter Reed National Military Medical Center
arlington, VA, United States

Senior Author(s)

Edward D. McCoul, MD, MPH

Professor
Ochsner Clinic
New Orleans, Louisiana, United States

Co-Author(s)

LT

Lily Trinh, MD

Resident
Tulane University
New Orleans, LA, United States

Disclosure(s):

Brianna L. Murphy, MD: No relevant relationships to disclose.

Introduction: Miscommunication between patients and providers can affect patient outcomes, delay treatment, and reduce satisfaction. Dizziness is a common reason patients seek otolaryngologic care and remains an incompletely understood complaint.

Methods: Between June 2020 and December 2022, attending otolaryngologists and consecutive patients at five academic institutions were provided a semantics-based questionnaire containing 20 common descriptors of the term ‘dizzy’. The primary outcome was differences between patient and clinician perceptions of dizzy-related symptoms covering five general categories including imbalance, lightheadedness, motion, vision, and pain.

Results: Responses were obtained from 276 patients (166 female [60.1%]; mean age [SD] 46.2 [15.0] years) and 31 otolaryngologists (12 female [38.7%]; mean age [SD] 40.3 [7.2] years). Patients and otolaryngologists selected 7.5±3.6 and 7.2±4.3 symptoms, respectively. Among patients, the most selected categories for dizziness were imbalance (251, 90.9%), lightheaded (248, 89.9%), and motion-related (228, 82.6%). Most patients (266, 96.4%) selected from more than one domain and 17 (6.2%) patients identified symptoms from each of the five domains. Otolaryngologists were more likely to define dizziness in terms of motion-related terms (difference, 10.9%; 95% CI, 1.2%-20.7%), whereas patients were more likely to include terms in vision (difference, 23.0%; 95% CI, 9.9%-36.1%) or pain-related (difference 17.8%; 95% CI, 9.9%-25.7%) domains.

Conclusions: Patients and otolaryngologists commonly described dizziness using symptoms related to imbalance and lightheadedness. Otolaryngologists were more likely to describe dizziness using motion-related terms, while patients were more likely to use vision or pain-related terms. Understanding of these semantic differences may enable more effective patient-clinician communication.