Identifying key risk factors for the recurrence of benign paroxysmal positional vertigo following successful canalith repositioning maneuvers: a meta analysis
Bibliographic record
Abstract
BACKGROUND: An increasing occurrence trend of benign paroxysmal positional vertigo (BPPV) after successful canalith repositioning maneuvers was observed; however, the risk elements for the occurrence of this disease remain undefined. We aimed to conduct a meta-analysis of BPPV occurrence-associated risk factors reported. METHODS: A comprehensive search in MEDLINE, EMBASE, PubMed, Springer, and the Cochrane Library up to March 31, 2024. The meta-analysis was carried out with STATA 16.0. Quality evaluation of the articles was performed with the Newcastle-Ottawa Scales (NOS). Data were pooled by a random-effects model. The meta-analysis was registered at INPLASY (202430045). RESULTS: Seventeen studies with 229 patients were included in the present analysis. The recurrence rate of BPPV after Canalith repositioning procedure (CRP) or Epley maneuver in subjects with hypertension [standardized mean difference (SMD) = 0.88,95% confidence interval (CI) (0.81-0.96), P = 0.00], Meniere's disease [SMD = 0.84, 95%CI (0.57-1.10), P = 0.00], head trauma [SMD = 0.48, 95%CI (0.34-0.63), P = 0.00], diabetes mellitus (DM) [SMD = 0.87, 95%CI (0.80-0.94), P = 0.00], advanced age [SMD = 0.18, 95%CI (0.08-0.28), P = 0.00], osteoporosis [SMD = 0.32, 95%CI (0.20-0.43), P = 0.00], female gender [SMD = 0.53, 95%CI (0.40-0.67), P = 0.00], migraine headache [SMD = 0.20, 95%CI (0.06-0.35), P = 0.01], and vitamin D deficiency [OR = 0.29, 95%CI (0.18-0.40), P = 0.00] were appreciably higher than those in patients without hypertension, Meniere's disease, head trauma, DM, advanced age, osteoporosis, female gender, migraine headache, and vitamin D deficiency. CONCLUSION: This meta-analysis has identified several significant risk factors associated with the recurrence of BPPV following successful canalith repositioning procedures. These include Meniere's disease, head trauma, diabetes mellitus, migraine headaches, female gender, advanced age, osteoporosis, and vitamin D deficiency.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.013 | 0.024 |
| Meta-epidemiology (narrow) | 0.003 | 0.002 |
| Meta-epidemiology (broad) | 0.016 | 0.063 |
| Bibliometrics | 0.006 | 0.006 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.004 | 0.001 |
| Open science | 0.002 | 0.001 |
| Research integrity | 0.003 | 0.002 |
| Insufficient payload (model declined to judge) | 0.003 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".