Dizziness Handicap Inventory in Clinical Evaluation of Dizzy Patients.

Ewa Zamyslowska-Szmytke,Magdalena Jozefowicz-Korczynska,Piotr Politanski

doi:10.3390/ijerph18052210

Ewa Zamyslowska-Szmytke, Magdalena Jozefowicz-Korczynska + Show 1 more

Open Access

https://doi.org/10.3390/ijerph18052210

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Abstract

(1) Objectives: The evaluation of dizzy patients is difficult due to nonspecific symptoms that require a multi-specialist approach. The Dizziness Handicap Inventory (DHI) is widely used in the assessment of dizziness-related disability, but its clinical efficacy needs further expansion. The aim of this study was to identify the subscales of DHI that may correlate with some vestibular or nonvestibular dysfunctions. (2) Material and methods: This observational study included 343 dizzy patients with one of the following clinical conditions: Vestibular impairment noncompensated or compensated, central or bilateral, benign paroxysmal positional vertigo (BPPV), migraine and psychogenic dizziness. Principal component analysis was used to examine the factorial structure of the questionnaire. (3) Results: The DHI questionnaire total scoring and its vestibular subscale distinguished between patients with compensated and uncompensated vestibular dysfunction with positive predictive values of 76% and 79%, respectively. The DHI items composing the F3 (positional) subscale revealed the highest scoring in the BPPV group with 75% sensitivity and 92% negative predictive value (NPV) in reference to Dix–Hallpike tests. The DHI total score and the subscales scores correlated with anxiety-depression, and the highest correlation coefficients were calculated for vestibular (F2 0.56) and anxiety (F5 0.51) subscales. (4) Conclusions: Our analysis revealed that the DHI vestibular subscale distinguishes between patients with compensated and uncompensated vestibular dysfunction. The positional subscale showed the highest scoring in the BPPV group with high sensitivity and low specificity of the test. The DHI is highly correlated with patients’ psychological status.

Highlights

Dizziness and/or vertigo are the most common reported medical complaints affecting15–35% of the adult population dependent on the study group [1,2]
The aim of our present study was to assess the Dizziness Handicap Inventory (DHI) results obtained from a cohort of patients with vestibular and nonvestibular signs using factor analysis
The main aim of the present study was to identify the individual subscales of the DHI, which would correlate with clinical tests in a cohort of patients with vestibular and nonvestibular vertigo or dizziness

Summary

Introduction

Dizziness and/or vertigo are the most common reported medical complaints affecting15–35% of the adult population dependent on the study group [1,2]. Dizziness and/or vertigo are the most common reported medical complaints affecting. Subjects reporting dizziness describe a range of sensations, such as feeling faint, woozy, weak, or unsteady. According to the Classification of Vestibular Disorders of the Barany Society, dizziness is defined as a nonvertiginous sensation of disturbed or impaired spatial orientation without a false or distorted sense of motion [3]. Diagnosis is usually difficult because these complaints are nonspecific and the differential diagnosis is broad. Dizziness is a cause of disability and inability to work. Primary care is the first point of contact for dizzy patients [4]. A self-reported questionnaire could be of great help in evaluating the clinical status of the patient. There are several questionnaires for vertigo and dizziness handicap assessment, e.g., Vestibular Disorders of Daily Living Scale (VADL); Activities-specific

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