Introduction
On March 20th 2020, ENT UK messaged all its members recommending that all routine clinics should be cancelled and telephone review should be the first approach for all outpatients who do not need urgent treatment(2). As seen in other countries(3), our ear, nose and throat (ENT) department wanted to try and reduce delays and distress to patients by impact by offering telephone assessments for suitable patients. Dizziness, has an estimated lifetime prevalence of 30%(4) and can be diagnosed from medical history(5-7) alone, making dizzy patients potentially suitable for telephone clinics.
Dizziness prevalence increases with age(8) and this is reflected in the patient demographic of patients referred to our centre. COVID-19 is more severe in older patients(9), hence it was even more important to reduce exposure of this population with the hospital environment where the risk of infections is highest.
We wanted to know if a questionnaire would make assessment and diagnosis of vestibular disorders easier over the telephone A number of studies have used questionnaires to facilitate diagnosis in patients complaining of dizziness(10, 11) but most of these have focused on one specific diagnosis e.g. BPPV10 or hyperventillation11. Others have looked at using questionnaire to assess severity of pathology(12, 13). We chose a dizziness questionnaire described by Roland et al(1) because it was short, validated by its developers and is able to differentiate peripheral vestibular pathology from other causes of dizziness(1). Such a distinction could enable clinicians to decide whether patients need further investigations, a face-to-face appointment, or referral to another specialty. This has the potential to reduce the number of visits to the hospital for each patient.
The objective of this study was to assess whether use of the Roland et al(1) dizziness questionnaire (RDQ) facilitated diagnosis, reduced the number of investigations and face-to-face appointments, increases discharges and whether it is helpful to clinicians and patients using it.