The evidence base for the evaluation and management of dizziness.
OBJECTIVE
Dizziness presentations pose many clinical challenges. The objective of this study is to broadly summarize the evidence base that supports clinical decisions in dizziness presentations.


METHODS
MEDLINE (1966 to September 2007), Web of Science and The Cochrane Library were searched for articles with clinical relevance on topics concerning dizziness. Additional sources were also searched for clinical practice guidelines. The following information was abstracted from each article: year of publication, journal type, type of article and the topics of the article.


RESULTS
Of nearly 3000 articles identified, 1244 articles met the inclusion criteria. The most common article type was a case report or case series, followed by expert opinion or review articles, studies of medical tests and clinical trials. Meta-analyses and systematic reviews were found on benign paroxysmal positional vertigo and Meniere's disease, but only a few other topics. No clinical practice guidelines were found that focus specifically on dizziness.


CONCLUSIONS
The evidence base for the evaluation and management of dizziness seems to be weak. Future work to establish or summarize evidence in clinically meaningful ways could contribute to efforts to optimize patient care and health care utilization for one of the most common presenting symptoms.
Kerber
Kevin A
KA
Department of Neurology, University of Michigan Health Systems (KAK), 1500 E. Medical Center Drive, Ann Arbor, MI 48109, USA. kakerber@umich.edu
Fendrick
A Mark
AM
D015706:Bibliometrics; D004244:Dizziness / Q000175:diagnosis / Q000628:therapy; D019317:Evidence-Based Medicine; D006801:Humans; D015201:Meta-Analysis as Topic; D017410:Practice Guidelines as Topic; D012196:Review Literature as Topic