Predicting brain-related causes of vertigo, dizziness, and unsteadiness in the emergency department
Lost in the Labyrinth: Predicting Central Neurological Causes of Vertigo Dizziness and Unsteadiness in the Emergency Department. A Multicentre Cross-sectional Observational Study
This research will test whether a bedside exam algorithm used by emergency doctors can tell if an adult's vertigo, dizziness, or unsteadiness is caused by a brain problem.
Quick facts
| Study type | Observational |
|---|---|
| Enrollment | 825 (estimated) |
| Ages | 18 Years and up |
| Sex | All |
| Sponsor | Fondazione IRCCS Policlinico San Matteo di Pavia Academic / other |
| Locations | 1 site (Pavia, Pavia) |
| Trial ID | NCT07287891 on ClinicalTrials.gov |
What this trial studies
This is a multicentre cross-sectional observational study enrolling adults who present to the emergency department with vertigo, dizziness, or unsteadiness. Emergency physicians will perform a standardized bedside examination algorithm and their findings will be recorded. Results will be compared to the clinical reference standard (including imaging and specialist diagnosis) to calculate sensitivity, specificity, and predictors of a central cause. The study excludes patients with dementia, bedridden status for unrelated reasons, or clear neurological deficits suggesting stroke at triage.
Who should consider this trial
Good fit: Adults aged 18 or older who present to the ED with vertigo, dizziness, or unsteadiness and can give informed consent, without dementia or unrelated bedridden status, are ideal candidates.
Not a fit: Patients with clear focal neurological deficits or suspected stroke at triage, people with dementia, bedridden patients for other reasons, and children are unlikely to benefit from participation.
Why it matters
Potential benefit: If successful, the algorithm could reduce misdiagnosis, lower unnecessary neuroimaging, shorten ED stays, and cut healthcare costs.
How similar studies have performed: Related bedside algorithms such as HINTS have shown high accuracy in expert hands but have variable validation in general emergency department settings, so prior results are promising but inconsistent.
Eligibility criteria
Show full inclusion / exclusion criteria
Inclusion Criteria: * Patients presenting at the ED with vertigo, dizziness or unsteadiness * \>= 18 years of age * Patients able to give their consent Exclusion Criteria: * Patients with dementia * Bedridden patients (for causes other than the current symptoms) * Patients with obvious neurological findings presenting with vertigo but with suspected stroke at triage
Where this trial is running
Pavia, Pavia
- SC Pronto Soccorso e Medicina d'Urgenza, Fondazione IRCCS Policlinico San Matteo — Pavia, Pavia, Italy (Recruiting)
Study contacts
- Study coordinator: Marco Bonzano, MD
- Email: m.bonzano@smatteo.pv.it
- Phone: +390382502039
How to participate
- Review the eligibility criteria above with your treating physician.
- Visit the official trial page on ClinicalTrials.gov for the most current contact information and recruitment status.
- Contact the listed study coordinator or principal investigator to request pre-screening. Pre-screening is free and never obligates you to enroll.