As possible candidate screening instruments for benign paroxysmal positional vertigo (BPPV), studies to validate the Dizziness Handicap Inventory (DHI) sub-scale (5-item and 2-item) and total scores are rare in China. From May 2014 to December 2014, 108(55 with and 53 without BPPV) patients complaining of episodic vertigo in the past week from a vertigo outpatient clinic were enrolled for DHI evaluation, as well as demographic and other clinical data. Objective BPPV was subsequently determined by positional evoking maneuvers under the record of optical Frenzel glasses. Cronbach’s coefficient α was used to evaluate the reliability of psychometric scales. The validity of DHI total, 5-item and 2-item questionnaires to screen for BPPV was assessed by receiver operating characteristic (ROC) curves. It revealed that the DHI 5-item questionnaire had good internal consistency (Cronbach’s coefficient α = 0.72). Area under the curve of total DHI, 5-item and 2-item scores for discriminating BPPV from those without was 0.678 (95 % CI 0.578–0.778), 0.873(95 % CI 0.807–0.940) and 0.895(95 % CI 0.836–0.953), respectively. It revealed 74.5 % sensitivity and 88.7 % specificity in separating BPPV and those without, with a cutoff value of 12 in the 5-item questionnaire. The corresponding rate of sensitivity and specificity was 78.2 and 88.7 %, respectively, with a cutoff value of 6 in 2-item questionnaire. The present study indicated that both 5-item and 2-item questionnaires in the Chinese version of DHI may be more valid than DHI total score for screening objective BPPV and merit further application in clinical practice in China.
This is a preview of subscription content, log in to check access.
The authors would like to thank Dr. Gang Wang from Rui Jin Hospital affiliated to Shanghai Jiao Tong University School of Medicine for design guidance and English proof reading. We are also grateful to Professor Yi-Min Zhu from Department of Epidemiology and Biostatistics, School of Medicine, Zhejiang University, for advice with the statistical analysis. This work was supported by Youth foundation of Shanghai Ninth People’s Hospital (2013, to Wei Chen), Science and Technology foundation of Shanghai Jiao Tong University, School of Medicine (2014, to Wei Chen) and National Natural Science Fund (81401039).
Compliance with ethical standards
Conflict of interest
We have no disclosure of any competing interest.
All procedures were in accordance with the ethical standards of the responsible committee on human experimentation and with the Helsinki Declaration.
Written and informed consents were obtained from all participants.
von Brevern M, Radtke A, Lezius F, Feldmann M, Ziese T et al (2007) Epidemiology of benign paroxysmal positional vertigo: a population based study. J Neurol Neurosurg Psychiatry 78:710–715CrossRefGoogle Scholar
van der Zaag-Loonen HJ, van Leeuwen RB, Bruintjes TD, van Munster BC (2015) Prevalence of unrecognized benign paroxysmal positional vertigo in older patients. Eur Arch Otorhinolaryngol 272:1521–1524CrossRefPubMedGoogle Scholar
Bhattacharyya N, Baugh RF, Orvidas L, Barrs D, Bronston LJ et al (2008) Clinical practice guideline: benign paroxysmal positional vertigo. Otolaryngol Head Neck Surg 139:S47–S81CrossRefPubMedGoogle Scholar
Fife TD, Iverson DJ, Lempert T, Furman JM, Baloh RW et al (2008) Practice parameter: therapies for benign paroxysmal positional vertigo (an evidence-based review): report of the Quality Standards Subcommittee of the American Academy of Neurology. Neurology 70:2067–2074CrossRefPubMedGoogle Scholar
Jacobson GP, Newman CW (1990) The development of the Dizziness Handicap Inventory. Arch Otolaryngol Head Neck Surg 116:424–427CrossRefPubMedGoogle Scholar
Poon DM, Chow LC, Au DK, Hui Y, Leung MC (2004) Translation of the dizziness handicap inventory into Chinese, validation of it, and evaluation of the quality of life of patients with chronic dizziness. Ann Otol Rhinol Laryngol 113:1006–1011CrossRefPubMedGoogle Scholar
Kurre A, van Gool CJ, Bastiaenen CH, Gloor-Juzi T, Straumann D et al (2009) Translation, cross-cultural adaptation and reliability of the german version of the dizziness handicap inventory. Otol Neurotol 30:359–367CrossRefPubMedGoogle Scholar
Nola G, Mostardini C, Salvi C, Ercolani AP, Ralli G (2010) Validity of Italian adaptation of the Dizziness Handicap Inventory (DHI) and evaluation of the quality of life in patients with acute dizziness. Acta Otorhinolaryngol Ital 30:190PubMedPubMedCentralGoogle Scholar
Castro AS, Gazzola JM, Natour J, Gananca FF (2007) Brazilian version of the dizziness handicap inventory. Pro Fono 19:97–104PubMedGoogle Scholar
Georgieva-Zhostova S, Kolev OI, Stambolieva K (2014) Translation, cross-cultural adaptation and validation of the Bulgarian version of the Dizziness Handicap Inventory. Qual Life Res 23:2103–2107CrossRefPubMedGoogle Scholar
Whitney SL, Marchetti GF, Morris LO (2005) Usefulness of the dizziness handicap inventory in the screening for benign paroxysmal positional vertigo. Otol Neurotol 26:1027–1033CrossRefPubMedGoogle Scholar
Saxena A, Prabhakar MC (2013) Performance of DHI score as a predictor of benign paroxysmal positional vertigo in geriatric patients with dizziness/vertigo: a cross-sectional study. PLoS One 8:e58106CrossRefPubMedPubMedCentralGoogle Scholar
Ensrud KE, Nevitt MC, Yunis C, Hulley SB, Grimm RH et al (1992) Postural hypotension and postural dizziness in elderly women. The study of osteoporotic fractures. The Study of Osteoporotic Fractures Research Group. Arch Intern Med 152:1058–1064CrossRefPubMedGoogle Scholar
Toupet M, Ferrary E, Grayeli AB (2011) Visual analog scale to assess vertigo and dizziness after repositioning maneuvers for benign paroxysmal positional vertigo. J Vestib Res 21:235–241PubMedGoogle Scholar
Jeong SH, Choi SH, Kim JY, Koo JW, Kim HJ et al (2009) Osteopenia and osteoporosis in idiopathic benign positional vertigo. Neurology 72:1069–1076CrossRefPubMedGoogle Scholar
Yamanaka T, Shirota S, Sawai Y, Murai T, Fujita N et al (2013) Osteoporosis as a risk factor for the recurrence of benign paroxysmal positional vertigo. Laryngoscope 123:2813–2816CrossRefPubMedGoogle Scholar