COSMIN database

A systematic review of patient-reported measures associated with vestibular dysfunction

Stewart, V. M., Mendis, M. D., and Low Choy, N.

HYPOTHESIS: Use of clinical questionnaires to assist in the screening of vestibular disorders in the acute hospital setting is needed. The objective is to detail the clinimetric properties and clinical utility of patient-reported questionnaires for quantifying dizziness/vertigo symptoms associated with vestibular dysfunction, and to determine validity and utility for screening dizziness/vertigo in the emergency department.

DATA SOURCES: We performed a systematic review of PubMed, CINAHL, Embase, and Web of Science in May 2015.

METHODS: Two independent reviewers selected studies reporting clinimetric properties of patient-reported questionnaires that aim to evaluate symptomology of dizziness/vertigo associated with vestibular dysfunction. A third reviewer resolved disparities. Of 1,901 articles initially found in the database search, 58 articles and 9 patient-reported questionnaires were included.

RESULTS: Clinimetric properties of content validity, criterion validity, internal consistency, inter-/intrarater reliability, test-retest reliability, and responsiveness to vestibular rehabilitation are reported, and methodological quality is rated using the COSMIN (Consensus-based Standards for the selection of health Measurement Instruments) checklist. Clinical utility is described in terms of target population, purpose, number of items, and whether the questionnaire was validated in the emergency department.

CONCLUSIONS: The Vestibular Rehabilitation Benefit Questionnaire, a relatively new tool, scored an "excellent" rating on three COSMIN criteria, and may be the best measure to address treatment outcomes. Questions on respective tools ranged from nine to 36, and no questionnaire was validated in the emergency department. Due to the number of questions and lack of validity, none of the questionnaires was deemed appropriate as a screening tool for dizziness/vertigo in the emergency department. Laryngoscope, 2017.
Publication year:
Symptom status:
Cognitive/mental state
Emotional state
Physical state
Functional status:
Role functioning
Social functioning
General health perceptions / HRQoL:
Self-rated health
Adults (18-65)
Seniors (65+)
Diseases of and symptoms related to the ear and mastoid process
PRO / non-PRO:
Patient Reported Outcome
Type of measurement instrument:
1 - Questionnaires
DHI - Dizziness Handicap Inventory
DHI-S - Dizziness Handicap Inventory–Screening
VADL - Vestibular Disorders Activities of Daily Living
VAP - vestibular activities and participation measure
VDI - Vertigo, Dizziness, Imbalance Questionnaire
VHQ - Vertigo Handicap Questionnaire
VRBQ - Vestibular Rehabilitation Benefit Questionnaire
VSS - Vertigo Symptom Scale
VVAS - Visual Vertigo Analogue Scale