title: [Peripheral vertigo classification of the Otoneurology Committee of the Spanish Otorhinolaryngology Society: diagnostic agreement and update (version 2-2011)].
abstract: BACKGROUND
  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.
authors.affiliation: Servicio de Otorrinolaringología, Complexo Hospitalario Universitario de Santiago, Santiago de Compostela, A Coruña, España. andres.soto@usc.es
authors.forename: Andrés
authors.initials: A
authors.lastname: Soto-Varela
authors.forename: Ismael
authors.initials: I
authors.lastname: Arán-González
authors.forename: José Antonio
authors.initials: JA
authors.lastname: López-Escámez
authors.forename: Constantino
authors.initials: C
authors.lastname: Morera-Pérez
authors.forename: Manuel
authors.initials: M
authors.lastname: Oliva-Domínguez
authors.forename: Nicolás
authors.initials: N
authors.lastname: Pérez-Fernández
authors.forename: Herminio
authors.initials: H
authors.lastname: Pérez-Garrigues
authors.forename: Paz
authors.initials: P
authors.lastname: Pérez-Vázquez
authors.forename: Marcos
authors.initials: M
authors.lastname: Rossi-Izquierdo
authors.forename: Sofía
authors.initials: S
authors.lastname: Santos-Pérez
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D032921:Consensus; D005260:Female; D006801:Humans; D008297:Male; D008499:Medical Records; D008875:Middle Aged; D015588:Observer Variation; D010036:Otolaryngology; D012955:Societies, Medical; D013030:Spain; D014717:Vertigo / Q000145:classification* / Q000175:diagnosis / Q000503:physiopathology; D055815:Young Adult