Neurological Sciences

, Volume 37, Issue 8, pp 1241–1246 | Cite as

Validation of 5-item and 2-item questionnaires in Chinese version of Dizziness Handicap Inventory for screening objective benign paroxysmal positional vertigo

  • Wei Chen
  • Liang Shu
  • Qian Wang
  • Hui Pan
  • Jing Wu
  • Jie Fang
  • Xu-Hong Sun
  • Yu Zhai
  • You-Rong Dong
  • Jian-Ren LiuEmail author
Original Article


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.


Benign paroxysmal positional vertigo Screening Dizziness Handicap Inventory Osteoporosis 



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.

Ethical approval

All procedures were in accordance with the ethical standards of the responsible committee on human experimentation and with the Helsinki Declaration.

Informed consent

Written and informed consents were obtained from all participants.


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Copyright information

© Springer-Verlag Italia 2016

Authors and Affiliations

  • Wei Chen
    • 1
  • Liang Shu
    • 1
  • Qian Wang
    • 1
  • Hui Pan
    • 1
  • Jing Wu
    • 1
  • Jie Fang
    • 1
  • Xu-Hong Sun
    • 1
  • Yu Zhai
    • 1
  • You-Rong Dong
    • 1
  • Jian-Ren Liu
    • 1
    Email author
  1. 1.Department of NeurologyShanghai Ninth People’s Hospital Affiliated to Shanghai Jiao Tong University School of MedicineShanghaiChina

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