A dizziness questionnaire is helpful when assessing patients with
dizziness in the telephone consultations during the COVID-19 pandemic
Abstract
Background: In March 2020, in response to the COVID19 outbreak, ENT UK
issued guidance 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. Our district general
hospital department therefore organised telephone reviews for all
patients referred with dizziness. It was decided to trial a
questionnaire to help clinicians with this new approach to assessing
patients with dizziness. Study Design: Prospective Single Centre
Randomised Pilot Study. Methods: Local ethics approved was obtained and
all 115 patients awaiting otolaryngological assessment for balance were
randomised to receive a validated dizziness questionnaire or not.
Questionnaires were posted to the patients prior to their appointment.
They were then contacted for a planned telephone consultation for
dizziness. Data on the outcome and effectiveness of the consultation was
collected by the clinicians conducting the consultation. Results were
analysed using Microsoft Excel and Fisher’s exact test was used for the
statistical analysis. Results: 82/115 patients had consultations with
complete data collection, 35 in the questionnaire group (QG) and 47 in
the no questionnaire group (NQG). Response rate (returned completed
questionnaires) in the QG was 70%. Clinicians were able to make a
provisional diagnosis in 77% of QG patients vs 57% of NQG patients. QG
patients only required additional investigations 26% of the time
compared to 72% in the NQG (p<0.05). Only 17% of QG patients
needed additional telephone follow up, compared to 43% of NQG patients
(P<0.05). Conclusion: Using an abbreviated dizziness
questionnaire can increase clinicians’ ability to come to a diagnosis at
the end of a telephone consultation. It may reduce the need for
additional investigations and further telephone follow-up, thereby
keeping patients away from the hospital and freeing up capacity.