title: Variation in the Use of Vestibular Diagnostic Testing for Patients Presenting to Otolaryngology Clinics with Dizziness.
abstract: We used a national otolaryngology practice-based research network database to characterize the utilization of vestibular function testing in patients diagnosed with dizziness and/or a vestibular disorder.
  
  
  
  Database review.
  
  
  
  The Creating Healthcare Excellence through Education and Research (CHEER) practice-based research network of academic and community providers
  
  
  
  Dizzy patients in the CHEER retrospective database were identified through ICD-9 codes; vestibular testing procedures were identified with CPT codes. Demographics and procedures per patient were tabulated. Analysis included number and type of vestibular tests ordered, stratified by individual clinic and by practice type (community vs academic). Chi-square tests were performed to assess if the percentage of patients receiving testing was statistically significant across clinics. A logistic regression model was used to examine the association between receipt of testing and being tested on initial visit.
  
  
  
  A total of 12,468 patients diagnosed with dizziness and/or a vestibular disorder were identified from 7 community and 5 academic CHEER network clinics across the country. One-fifth of these patients had at least 1 vestibular function test. The percentage of patients tested varied widely by site, from 3% to 72%; academic clinics were twice as likely to test. Initial visit vestibular testing also varied, from 0% to 96% of dizzy patients, and was 15 times more likely in academic clinics.
  
  
  
  There is significant variation in use and timing of vestibular diagnostic testing across otolaryngology clinics. The CHEER network research database does not contain outcome data. These results illustrate the critical need for research that examines outcomes as related to vestibular testing.
authors.affiliation: Division of Head and Neck Surgery and Communication Sciences, Department of Surgery, Duke University Medical Center, Durham, North Carolina, USA erin.piker@duke.edu.
authors.forename: Erin G
authors.initials: EG
authors.lastname: Piker
authors.affiliation: Division of Head and Neck Surgery and Communication Sciences, Department of Surgery, Duke University Medical Center, Durham, North Carolina, USA.
authors.forename: Kris
authors.initials: K
authors.lastname: Schulz
authors.affiliation: Division of Otolaryngology-Head and Neck Surgery, Department of Surgery, University of Connecticut Health, Farmington, Connecticut, USA.
authors.forename: Kourosh
authors.initials: K
authors.lastname: Parham
authors.affiliation: Department of Otolaryngology, Hofstra North Shore-LIJ School of Medicine, Long Island Jewish Medical Center, New Hyde Park, New York, USA.
authors.forename: Andrea
authors.initials: A
authors.lastname: Vambutas
authors.affiliation: Division of Head and Neck Surgery and Communication Sciences, Department of Surgery, Duke University Medical Center, Durham, North Carolina, USA.
authors.forename: David
authors.initials: D
authors.lastname: Witsell
authors.affiliation: Division of Head and Neck Surgery and Communication Sciences, Department of Surgery, Duke University Medical Center, Durham, North Carolina, USA.
authors.forename: Debara
authors.initials: D
authors.lastname: Tucci
authors.affiliation: Division of Otolaryngology, Harvard Medical School, Boston, Massachusetts, USA.
authors.forename: Jennifer J
authors.initials: JJ
authors.lastname: Shin
authors.affiliation: Department of Otolaryngology, University of Michigan, Ann Arbor, Michigan, USA.
authors.forename: Melissa A
authors.initials: MA
authors.lastname: Pynnonen
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Oregon Health & Science University, Portland, Oregon, USA.
authors.forename: Anh
authors.initials: A
authors.lastname: Nguyen-Huynh
authors.affiliation: Division of Head and Neck Surgery and Communication Sciences, Department of Surgery, Duke University Medical Center, Durham, North Carolina, USA.
authors.forename: Matthew
authors.initials: M
authors.lastname: Crowson
authors.affiliation: Division of Head and Neck Surgery and Communication Sciences, Department of Surgery, Duke University Medical Center, Durham, North Carolina, USA.
authors.forename: Sheila E
authors.initials: SE
authors.lastname: Ryan
authors.affiliation: Northwest Hearing & Balance Group, Seattle, Washington, USA.
authors.forename: Alan
authors.initials: A
authors.lastname: Langman
authors.affiliation: Duke Clinical Research Institute, Durham, North Carolina, USA.
authors.forename: Rhonda
authors.initials: R
authors.lastname: Roberts
authors.affiliation: Duke Clinical Research Institute, Durham, North Carolina, USA.
authors.forename: Anne
authors.initials: A
authors.lastname: Wolfley
authors.affiliation: Division of Head and Neck Surgery and Communication Sciences, Department of Surgery, Duke University Medical Center, Durham, North Carolina, USA.
authors.forename: Walter T
authors.initials: WT
authors.lastname: Lee
mesh_terms: D016208:Databases, Factual; D003937:Diagnosis, Differential; D004244:Dizziness / Q000175:diagnosis* / Q000453:epidemiology; D005260:Female; D006302:Health Services Research; D006801:Humans; D038801:International Classification of Diseases; D008297:Male; D008875:Middle Aged; D010036:Otolaryngology / Q000458:organization & administration; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D014481:United States / Q000453:epidemiology; D015837:Vestibular Diseases / Q000175:diagnosis / Q000453:epidemiology; D014724:Vestibular Function Tests / Q000379:methods*
keywords: diagnostic testing; dizziness; rotary chair; vestibular; videonystagmography