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Acta Otorrinolaringol Esp. 2012 Mar-Apr;63(2):125-31. doi: 10.1016/j.otorri.2011.10.004. Epub 2011 Dec 14.

[Peripheral vertigo classification of the Otoneurology Committee of the Spanish Otorhinolaryngology Society: diagnostic agreement and update (version 2-2011)].

[Article in Spanish]

Author information

1
Servicio de Otorrinolaringología, Complexo Hospitalario Universitario de Santiago, Santiago de Compostela, A Coruña, España. andres.soto@usc.es

Abstract

INTRODUCTION:

In 2008, the Otoneurology committee of the SEORL-PCF published a classification of peripheral vertigo, based on clinical criteria. The objective of this study was to validate this classification through analysing the diagnostic agreement among several medical assessors.

METHODS:

Seven medical assessors, all with clinical experience, from 6 different hospitals, participated in the study. One of them selected the clinical histories of 50 consecutive patients who had consulted as a result of balance disorders (24 men and 26 women) with an average age of 53.5 years. These clinical histories -without any information that would identify the patient, the diagnosis established and the treatment- were sent to another 6 assessors. Each of these investigators established their own diagnosis, trying to adjust it to the epigraphs of the classification.

RESULTS:

Of the 50 patients, there was substantial agreement as to the diagnosis (4 or more evaluators indicated the same one) in 31 cases (26 with a positive diagnosis and 5 with a negative one, which could not be included in any epigraph). The kappa index, which measures the level of accordance between 2 or more assessors, was 0.4198 (moderate level of agreement). Unanimity was achieved in only 7 cases (4 BPPV, 2 Ménière's disease and 1 vertigo associated with migraine).

CONCLUSIONS:

The current classification, with the criteria it includes, allows labelling with an acceptable consensus to only 62% of the patients. Therefore, a modification in the classification is proposed in relation with the probable BPPV epigraph, as well a revision of the entries for vertigo-migraine and vertigo associated with migraine.

PMID:
22169589
DOI:
10.1016/j.otorri.2011.10.004
[Indexed for MEDLINE]
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