Introduction
On March 20th 2020, ENT UK messaged all its members
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(2). As seen in other countries(3), our ear, nose and
throat (ENT) department wanted to try and reduce delays and distress to
patients by impact by offering telephone assessments for suitable
patients. Dizziness, has an estimated lifetime prevalence of 30%(4) and
can be diagnosed from medical history(5-7) alone, making dizzy patients
potentially suitable for telephone clinics.
Dizziness prevalence increases with age(8) and this is reflected in the
patient demographic of patients referred to our centre. COVID-19 is more
severe in older patients(9), hence it was even more important to reduce
exposure of this population with the hospital environment where the risk
of infections is highest.
We wanted to know if a questionnaire would make assessment and diagnosis
of vestibular disorders easier over the telephone A number of studies
have used questionnaires to facilitate diagnosis in patients complaining
of dizziness(10, 11) but most of these have focused on one specific
diagnosis e.g. BPPV10 or
hyperventillation11. Others have looked at using
questionnaire to assess severity of pathology(12, 13). We chose a
dizziness questionnaire described by Roland et al(1) because it was
short, validated by its developers and is able to differentiate
peripheral vestibular pathology from other causes of dizziness(1). Such
a distinction could enable clinicians to decide whether patients need
further investigations, a face-to-face appointment, or referral to
another specialty. This has the potential to reduce the number of visits
to the hospital for each patient.
The objective of this study was to assess whether use of the Roland et
al(1) dizziness questionnaire (RDQ) facilitated diagnosis, reduced the
number of investigations and face-to-face appointments, increases
discharges and whether it is helpful to clinicians and patients using
it.