Table 1.
Characteristics of selected studies
| Study, country | Study design, data source | Setting | Time frame | Included vertigo type | Study sample (size, selection criteria, age, gender) | Type of reported burden |
|---|---|---|---|---|---|---|
| Adams, M.E., et al., 2017 [32]; USA | retrospective review of Medicare data Health Care Financing Administration Common ProcedureCoding System | different geographic regions of the USA | 2000–2010 | dizziness, not otherwise specified, vertigo of central origin; MD; BPPV; other peripheral vestibular disease |
5798 patients with vestibular testing from 63,578 with vestibular diagnosis; from total 231,984 patients • inclusion: age ≥ 65 • mean age not reported; 68% female |
resource use for diagnostic investigations in rate of population |
| Ahsan, S.F., et al., 2013 [33]; USA | retrospective chart review | emergency department | January 2008–January 2011 | ICD–9 codes 386.11 (BPPV) or 780.4 (Dizziness and giddiness) |
1681 patients • inclusion: ED visit due to vertigo; being assigned to the health system’s health maintenance organization, for clinical and cost data accessibility • exclusion: history of severe neurologic diseases • mean age 56.9; 67.2% female |
resource use for imaging in rate of population and monetised cost aggregated to a clinic and projected to positive yield |
| Ammar, H., et al.,2017 [34]; USA | retrospective chart review | emergency department | January 1, 2011 – December 31, 2011 | ICD-9 codes 780.4 (Dizziness and giddiness), 781.2 (Abnormality of gait, 386.0 (MD), 386.1 (Other and unspecified peripheral vertigo), 386.2 (Vertigo of central origin) |
521 patients • inclusion: ED visit due to dizziness; age ≥ 18 • exclusion: syncope • mean age 49.3; 57.8% female |
• resource use for specialist visit in rate of population • resource use for imaging in rate of population and monetised cost aggregated to a clinic and projected to positive yield • resource use for hospitalisations in number of occasions per patient and in rate of population |
| Benecke, H., et al., 2013 [35]; Czech Republic, Germany, Hungary, Slovenia | multi-country, observational, data of Registry to Evaluate the Burden of Disease in Vertigo | general practitioners, specialists (ear-nose-throat, neurologist), emergency department | April 20, 2007 - August 15, 2009 | MD, BPPV, other vertigo of peripheral vestibular origin, or peripheral vestibular vertigo of unknown origin |
4294 patients of incident vertigo included in the registry, of which from • Czech Republic 559 • Germany 99 • Hungary 1320 • Slovenia 130 • 65.3% female |
• resource use for primary care, specialist, and ED visits and hospitalisations in number of occasions per patient • indirect: work absenteeism in number of occasions per patient; disability in rate of population |
| Gandolfi, M.M., et al.,2015 [36]; USA | retrospective chart review | academic specialty centre | January 1, 2010 - August 30, 2013 | Unilateral Vestibular Weakness |
• 1358 included patients from 1996 vertigo patients • inclusion: visit due to vertigo, unilateral caloric weakness (≥20%), abnormal ocular motor testing, and nystagmus on positional testing • mean age 62; 69.4% female |
resource use for imaging in rate of population and monetised cost aggregated to a clinic and projected to positive yield |
| Grill, E., et al.,2014 [37]; Germany | retrospective cohort study; patient-reported questionnaire data | all level health services utilization prior to visiting a tertiary care centre | 2011 to 2012 | BPPV, MD, vestibular paroxysmia, functional vertigo, bilateral vestibulopathy, vestibular migraine |
2374 patients of a tertiary vertigo centre as convenience sample • inclusion: age ≥ 18 • mean age 55.3; 59.8% female |
resource use for primary care visits, diagnostic investigations, imaging, medication, and therapeutic measures in rate of population |
| Lin and Bhattacharyya, 2011 [38]; USA | retrospective chart review on national level from National Ambulatory Medical Care Survey | all outpatient visits, national level | 2005 to 2007 | ICD–9 codes 386.00, 386.03 (MD), 386.12 (Vestibular neuritis), 386.11 (BPPV), 386.10, 386.19, 386.20, 438.85, 386.10 (other vertigo); [sensorineural hearing Loss] |
4.48 million outpatient visits due to an otologic diagnosis; patient number not provided • age ≥ 65 • mean age 77.4, 63% female |
resource use in rate of population for all outpatient and specialist visits, and in number of occasions aggregated to national level |
| McDowell, T. and F. Moore, 2016 [39]; Canada | retrospective chart review | emergency department | 1 January 1, 2011 - December 31, 2011 | ICD–9 codes 386.11 (BPPV) or 780.4 (Dizziness and giddiness) |
642 included patients from 1196 vertigo patients • exclusion: non-neurovestibular vertigo • mean age 63; 60.3% female |
resource use for imaging, specialist visit, and diagnostic investigation in rate of population |
| Neuhauser, H.K., et al.,2008 [40]; Germany | cross-sectional, questionnaire data from the National Health Interview Survey | German representative sample | 12 months prior to the interview in 2003 | MD, migrainous vertigo, orthostatic dizziness, and BPPV |
1003 individuals with dizziness/vertigo from the 4869 participants • 243 vestibular vertigo • 742 nonvestibular dizziness • 18 uncatogorised • age range 18–79 years |
• resource use for primary care and specialist visits, and hospitalisation in rate of population • indirect: work absenteeism and disability in rate of population |
| Reddy et al., 2011 [41]; UK | prospective cohort | nurse-led dizziness clinic | July 2007 to May 2009 | BPPV |
99 consecutive patients • 25 males, mean age 61 years; • 74 females, mean age 58.2 |
monetised cost per patient for specialist visit |
| Saber Tehrani, A.S., et al., 2013 [42]; USA | time-series cost analysis; prevalence data from the National Hospital Ambulatory Medical Care Survey (1995–2000, 2005–2009); cost data (2003 to 2008) from the Medical Expenditure Panel | emergency department, national level | estimated for 2011 | ICD-9 codes 780.4 (Dizziness and giddiness) or 386.x (Vertiginous syndromes and other disorders of vestibular system) |
12,202 dizziness visit and 360,424 non- dizziness visits in 15-years • inclusion: age ≥ 16 |
• resource use in number of occasions and in rate of visits for ED visit aggregated to national level • monetised cost per patient and aggregated to national level for ED visit • resource use in rate of population and in monetised cost aggregated to national level for imaging |
| Skoien et al., 2008 [43]; Norway | register-based prospective study, National Insurance Services data | national level | 1996–2002 | H82 (vertiginous syndrome), and N17 (vertigo/dizziness) | 694 female and 326 male vertigo patients from 920,139 women and 1,019,216 men | indirect: disability in rate of population |
| Sun, D.Q., et al., 2014 [44]; USA | cross-sectional; patient-reported Dizziness Handicap Index and Health Utilities Index Mark 3; costs based on Medicare reimbursement figures and US Bureau of Labor Statistics data | academic medical centre | 12 months prior to the survey in 2013 | Vestibular deficiency including MD, verified by caloric nystagmography |
15 patients with bilateral vestibular deficiency (BVD) and 22 patients with unilateral vestibular deficiency (UVD); 23 healthy controls • BVD: mean age 65, 27% female UVD: mean age 62, 59% female |
• resource use in number of occasions and monetised cost per patient for ED visit, and hospitalisation • Indirect: work absenteeism and consequences in number of occasions per patient |
| Tyrrell et al., 2016 [45]; UK | retrospective chart review, data from UK Biobank 2007–2012; Hospital Episode Statistics, UK Meniere’s Society. | national estimation | 2013–2014 | ICD-10 H810 (MD) |
1376 patients from 502,682 UK Biobank participants • 37–73 years • Extrapolated toyearly incidence: 2719 cases (i.e. 4.3 per 100,000 estimated prevalence: (0.25%; ~ 162,000 patients) |
• resource use in number of occasions per patient and monetised costs aggregated to national level for primary care, specialist, and ED visits • monetised costs aggregated to national level for imaging, diagnostic investigation, medication, therapeutic measures, and total direct cost • Indirect: work absenteeism, disability, and consequences in monetised costs aggregated to national level |
| Wiltink, J., et al., 2009 [46]; Germany | cross-sectional interview-based survey | German representative sample | 12 months prior to the survey in 2006 | patient-reported dizziness in the past 4 weeks |
201 dizziness patients from 1269 participants • all participants: mean age 48.8; 54.6% female • vertigo patients: mean age 58.8; 59.7% female |
• resource use in number of occasions per patient and in rate of population for primary care visits • resource use in rate of population for hospitalisation, medication, and therapeutic measures • Indirect: consequences in rate of population |
| Yardley et al., 2012 [47]; UK | three arm, pragmatic, randomised controlled trial | primary care | October 2008 to January 2011 | Vestibular vertigo, assessed by the primary health care provider |
337 patients participating in any of the survey waves; 263 in all • inclusion: vertigo-related diagnostic and medication terms in practice records • exclusion: non-labyrinthine cause of dizziness, serious comorbidity, language barriers • mean age 59.4; 71% female |
monetised total direct cost per patient |
BPPV Benign Paroxysmal Positional Vertigo, BVD bilateral vestibular deficiency, UVD unilateral vestibular deficiency, MD Meniere’s disease, ED emergency department