title: [Misdiagnosis and associated costs of benign paroxysmal positional vertigo].
abstract: Objective:The aims of this study were to investigate the misdiagnosis of benign paroxysmal positional vertigo (BPPV) and to estimate the associated costs.Methods:During October 2015 to December 2015, eighty patients were diagnosed with BPPV in the outpatient dizziness clinic of Shanghai Changzheng Hospital and the clinical data of all the 80 patients were collected including the demographic and clinical characteristics, the history of diagnosis, inappropriate diagnostic tests, costs of the medical tests, transportation and accommodation. All the data were investigated to estimate the misdiagnosis of benign paroxysmal positional vertigo and the associated costs in Shanghai, China.Results:This study showed that the misdiagnosis rate of BPPV was 60.0% (48/80) and the common inappropriate diagnostic tests for BPPV included Cranial CT and MRI test, cervical MRI, cervical and cerebrovascular investigations et al. There was no significant difference between the misdiagnosis patients (48) and patients without misdiagnosis (32) in gender, age, duration of symptom, involved canal and type of BPPV.Complications were significantly more frequent in the misdiagnosis group than for those without[81.3%(39 /48) vs 34.4%(11 /32)]. The estimated costs for each misdiagnosed individual were 8 502.98 China Yuan (CNY) and one-year economic burden associated with the misdiagnosis of BPPV in Shanghai was 13.184 7-78.862 1 million CNY.Conclusions:Our study suggests that the misdiagnosis rate of BPPV is high and the financial impact on patients and society with this disease is huge. The cost-effective Dix-Hallpike or supine roll test maneuver should be used before applying other expensive medical tests in order to minimize misdiagnosis and the waste of health care resources.
authors.affiliation: Department of Neurology, the Second Affiliated Hospital of Jiaxing College, Jiaxing 314000, China.
authors.forename: S X
authors.initials: SX
authors.lastname: Qian
authors.forename: F
authors.initials: F
authors.lastname: Li
authors.forename: J H
authors.initials: JH
authors.lastname: Zhuang
authors.forename: Y
authors.initials: Y
authors.lastname: Chen
authors.forename: H L
authors.initials: HL
authors.lastname: Yang
authors.forename: X W
authors.initials: XW
authors.lastname: Zhou
authors.forename: H H
authors.initials: HH
authors.lastname: Gu
authors.forename: B
authors.initials: B
authors.lastname: Gao
mesh_terms: D065635:Benign Paroxysmal Positional Vertigo / Q000175:diagnosis*; D002681:China; D003951:Diagnostic Errors; D004244:Dizziness; D006801:Humans; D008279:Magnetic Resonance Imaging; D014057:Tomography, X-Ray Computed; D014186:Transportation
keywords: Benign paroxysmal positional vertigo; Cost; Misdiagnosis