Patients’ Experiences with Management of Benign Paroxysmal Positional Vertigo: Insights from the Vestibular Disorders Association Registry
Bibliographic record
Abstract
Colin R Grove,1 Wagner Henrique Souza,2 Patricia L Gerend,3 Cynthia A Ryan,3 Michael C Schubert1,4 1Department of Otolaryngology - Head and Neck Surgery, Laboratory for Vestibular NeuroAdaptation, Johns Hopkins University, Baltimore, MD, 21205, USA; 2KITE, Toronto Rehabilitation Institute – University Health Network, Toronto, ON M5G 2A2, Canada; 3Vestibular Disorders Association (VeDA), Portland, OR, 97211, USA; 4Department of Physical Medicine and Rehabilitation, Johns Hopkins University, Baltimore, MD, 21205, USACorrespondence: Michael C Schubert, Department of Otolaryngology - Head and Neck Surgery, Johns Hopkins University, 601 N. Caroline Street, 6th Floor, Baltimore, MD, 21205, USA, Tel +1 410 955 7381, Email mschube1@jhmi.eduIntroduction: Benign paroxysmal positional vertigo (BPPV) is the most frequently occurring peripheral vestibular disorder. Clinical practice guidelines (CPG) for BPPV exist; however, little is known about how affected patients perceive their condition is being managed. We aimed to leverage registry data to evaluate how adults who report BPPV are managed.Material and Methods: We retrospectively analyzed of data from 1,262 adults (58.4 ± 12.6 years old, 81.1% female, 91.1% White) who were enrolled in the Vestibular Disorders Association Registry from 2014 to 2020. The following patient-reported outcomes were analyzed by proportions for those who did and did not report BPPV: symptoms experienced, falls reported, diagnostics undertaken, interventions received (eg, canalith repositioning maneuvers [CRMs], medications), and responses to interventions.Results: Of the 1,262 adults included, 26% reported being diagnosed with BPPV. Many adults who reported BPPV (83%) also endorsed receiving additional vestibular diagnoses or may have had atypical BPPV. Those with BPPV underwent magnetic resonance imaging and were prescribed medications more frequently than those without BPPV (76% vs 57% [χ2=36.51, p< 0.001] and 85% vs 78% [χ2=5.60, p=0.018], respectively). Falls were experienced by similar proportions of adults with and without BPPV (55% vs 56% [χ2==11.26, p=0.59]). Adults with BPPV received CRMs more often than those without BPPV (86% vs 48%, χ2=127.23, p< 0.001). More registrants with BPPV also endorsed benefit from CRMs compared to those without BPPV (51% vs 12% [χ2=105.30, p< 0.001]).Discussion: In this registry, BPPV was often reported with other vestibular disorders. Healthcare utilization was higher than would be expected with care based on the CPG. The rates of falls in those with and without BPPV are higher than previously reported. Adults with BPPV reported significant differences in how their care is managed and their overall outcomes compared to those without BPPV.Conclusion: Patient-reported outcomes provide useful information regarding the lived experience of adults with BPPV.Keywords: benign paroxysmal positional vertigo, vestibular disorders, falls, canalith repositioning maneuvers
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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 | 0.001 | 0.006 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.002 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.002 | 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".