title: Construction and Validation of the Vestibular Screening Tool for Use in the Emergency Department and Acute Hospital Setting.
abstract: OBJECTIVE
  To construct a new vestibular screening tool to identify likely vestibular disorders and guide referral of dizzy patients presenting to hospital and to test the vestibular screening tool for construct and discriminative validity and reliability of physiotherapy assessors.
  
  
  METHODS
  Methodologic study.
  
  
  METHODS
  Emergency and acute hospital wards of a metropolitan hospital.
  
  
  METHODS
  Adults (N=114) presenting to hospital with dizziness (mean age, 67.36±14.88y; 57% women).
  
  
  METHODS
  Not applicable.
  
  
  METHODS
  Three vestibular screening tools (3, 4, and 5 items) were investigated. Physiotherapy vestibular diagnostic tests categorized patients as vestibular or nonvestibular patients. Subsets of patients were assessed twice by 2 physiotherapists (n=20) and twice by the same physiotherapist (n=30).
  
  
  RESULTS
  Each of the vestibular screening tools had a good fit to the Rasch measurement model. Factor analysis demonstrated individual items loaded across 1 factor, confirming unidimensionality of the 3 vestibular screening tools, and Cronbach α determined internal consistency. The 4-item vestibular screening tool had the greatest area under the curve using receiver operator curve analysis (.894), with highest sensitivity (83%) and specificity (84%) for identifying vestibular disorders (cutoff value ≥4/8). Sensitivity of the 3- and 5-item versions was lower than the 4-item vestibular screening tool (80%). The 4-item vestibular screening tool scores showed high intrarater (κ item scores, .831-1; intraclass correlation coefficient [ICC] total, .988) and interrater (κ item scores, .578-.921; ICC total, .878) reliability.
  
  
  CONCLUSIONS
  The 4-item vestibular screening tool is a reliable, valid tool for screening dizzy patients presenting to hospital, with unidimensional construct validity, high sensitivity, and specificity for identifying likely vestibular disorders. The vestibular screening tool could be used clinically to streamline referrals of dizzy patients to vestibular clinics.
authors: Emergency Department, The Prince Charles Hospital, Chermside, Queensland, Australia; Internal Medicine Department, The Prince Charles Hospital, Chermside, Queensland, Australia; Physiotherapy Department, The Prince Charles Hospital, Chermside, Queensland, Australia; School of Physiotherapy, Faculty of Health Sciences, Australian Catholic University, Brisbane, Queensland, Australia. Electronic address: vicky_stewart@hotmail.com.au.
authors: Vicky
authors: V
authors: Stewart
authors: Centre for Musculoskeletal Research, Mary Mackillop Institute for Health Research, Australian Catholic University, Brisbane, Queensland, Australia.
authors: M Dilani
authors: MD
authors: Mendis
authors: Internal Medicine Department, The Prince Charles Hospital, Chermside, Queensland, Australia.
authors: Jeffrey
authors: J
authors: Rowland
authors: Internal Medicine Department, The Prince Charles Hospital, Chermside, Queensland, Australia; Physiotherapy Department, The Prince Charles Hospital, Chermside, Queensland, Australia; School of Physiotherapy, Faculty of Health Sciences, Australian Catholic University, Brisbane, Queensland, Australia.
authors: Nancy Low
authors: NL
authors: Choy
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003937:Diagnosis, Differential; D004244:Dizziness / Q000175:diagnosis*; D004636:Emergency Service, Hospital; D005163:Factor Analysis, Statistical; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015203:Reproducibility of Results; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires / Q000592:standards*; D015837:Vestibular Diseases / Q000175:diagnosis*
keywords: Dizziness; Emergency service, hospital; Questionnaires; Rehabilitation; Vertigo; Vestibular diseases