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‘Easy-to-use’ risk score predicts unfavorable course of dizziness in older patients
A risk score using four predictors that researchers deemed “easy-to-use” correctly identified patients older than 65 years at high risk for an unfavorable course of dizziness, according to findings recently published in Annals of Family Medicine.
“Dizziness in older people is ... often a diagnostic challenge for physicians because it can refer to a variety of sensations, as there are many potential underlying causes, and there is often a multifactorial origin. As a result, primary care physicians often manage dizziness in this age-group with a wait-and-see strategy, although they could also focus on targeting potential contributing factors such as multiple drug use or depressive symptoms,” Hanneke Stam, MD, of the Amsterdam Public Health Research Institute, and colleagues wrote.
Researchers in the Netherlands used data from two cohorts to develop the prediction tool. The development cohort included 203 patients aged 65 and older who presented to their PCP for dizziness and had a Dizziness Handicap Inventory score of 30 or more. A validation cohort included 415 patients aged 65 and older who presented to their PCP for any severity of dizziness. In the development cohort, the prevalence of an unfavorable course of dizziness was 73.9%, and in the validation cohort, the prevalence was 43.6%.
The researchers included the following predictors in their model: Dizziness Handicap Inventory score, age, history of arrhythmia and looking up as a provoking factor. The model showed good calibration and fair discrimination (area under the curve = 0.77). On external validation, discriminative ability remained stable (area under the curve = 0.78).
“The model discriminates fairly well between patients with and without high risk for an unfavorable course of dizziness,” Stam and colleagues wrote.
“With the presented risk score, primary care physicians will be able to easily detect older dizzy patients at high risk for an unfavorable course of dizziness. This identification could prompt the physician to consider targeting factors potentially contributing to dizziness in these high-risk patients, even when the cause is unclear.”– by Janel Miller
Disclosure: The authors report no relevant financial disclosures.