A critical appraisal of clinical practice guidelines for the diagnosis and management of benign paroxysmal positional vertigo

Abstract

Background Delays in the diagnosis and therapy of benign paroxysmal positional vertigo can greatly impact quality of life and increase healthcare costs for patients. This study aimed to appraise the quality of clinical practice guidelines for the diagnosis and management of benign paroxysmal positional vertigo. Methods A comprehensive database search of clinical practice guidelines was completed up to 30 October 2021. Four independent reviewers used the Appraisal of Guidelines for Research and Evaluation II instrument in the quality appraisal. Results The highest score was in ‘clarity and presentation’ (58.33 ± 22.7). The lowest score was in ‘applicability’ (13.96 ± 30.1). Overall, four clinical practice guidelines were ‘low quality’ and only one guideline was ‘high quality’. Conclusion This review identified a significant lack of quality in clinical practice guideline development for benign paroxysmal positional vertigo, highlighting the need for a more rigorous approach for future guideline development.

Functional ear symptoms, benign positional vertigo, arytenoid (vocal process) granuloma and early registrar training

“…3 Benign paroxysmal positional vertigo (BPPV) and its clinical subtypes have been a regular feature of The Journal, 4 and comprise a significant proportion of the clinical caseload in balance clinics, 5 with the condition often initially misdiagnosed. This issue has a paper from several centres in the USA, which assesses clinical practice guidelines for BPPV, 6 and emphasises the potential for such guidelines in improving speed of diagnosis and evidence-based treatment outcomes for this common condition. The authors find that some of the current guidelines are disappointing, failing to achieve what could be expected or hoped for from such guidelines, but the American Academy of Otolaryngology -Head and Neck Surgery guidelines perform better in meeting their criteria in the various domains.…”