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A dizziness questionnaire is helpful when assessing patients with dizziness in the telephone consultations during the COVID-19 pandemic
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  • Anna Kaleva,
  • Laura Leach,
  • F. Fahmy,
  • Lucy Truman,
  • Marcos Martinez Del Pero
Anna Kaleva
Luton & Dunstable NHS Trust
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Laura Leach
Department of Otorhinolaryngology, Peterborough City Hospital, North West Anglia NHS Foundation Trust, UK
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F. Fahmy
West Suffolk & Addenbrooke`s Hospitals
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Lucy Truman
Addenbrooke's Hospital
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Marcos Martinez Del Pero
Cambridge Teaching Hospitals
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Abstract

Background: In March 2020, in response to the COVID19 outbreak, ENT UK issued guidance recommending that all routine clinics should be cancelled and telephone review should be the first approach for all outpatients who do not need urgent treatment. Our district general hospital department therefore organised telephone reviews for all patients referred with dizziness. It was decided to trial a questionnaire to help clinicians with this new approach to assessing patients with dizziness. Study Design: Prospective Single Centre Randomised Pilot Study. Methods: Local ethics approved was obtained and all 115 patients awaiting otolaryngological assessment for balance were randomised to receive a validated dizziness questionnaire or not. Questionnaires were posted to the patients prior to their appointment. They were then contacted for a planned telephone consultation for dizziness. Data on the outcome and effectiveness of the consultation was collected by the clinicians conducting the consultation. Results were analysed using Microsoft Excel and Fisher’s exact test was used for the statistical analysis. Results: 82/115 patients had consultations with complete data collection, 35 in the questionnaire group (QG) and 47 in the no questionnaire group (NQG). Response rate (returned completed questionnaires) in the QG was 70%. Clinicians were able to make a provisional diagnosis in 77% of QG patients vs 57% of NQG patients. QG patients only required additional investigations 26% of the time compared to 72% in the NQG (p<0.05). Only 17% of QG patients needed additional telephone follow up, compared to 43% of NQG patients (P<0.05). Conclusion: Using an abbreviated dizziness questionnaire can increase clinicians’ ability to come to a diagnosis at the end of a telephone consultation. It may reduce the need for additional investigations and further telephone follow-up, thereby keeping patients away from the hospital and freeing up capacity.