eprintid: 10137404 rev_number: 23 eprint_status: archive userid: 608 dir: disk0/10/13/74/04 datestamp: 2021-11-02 14:37:17 lastmod: 2022-08-17 14:04:25 status_changed: 2021-11-02 14:37:17 type: article metadata_visibility: show creators_name: Bamiou, D-E creators_name: Kikidis, D creators_name: Bibas, T creators_name: Koohi, N creators_name: Macdonald, N creators_name: Maurer, C creators_name: Wuyts, FL creators_name: Ihtijarevic, B creators_name: Celis, L creators_name: Mucci, V creators_name: Maes, L creators_name: Van Rompaey, V creators_name: Van de Heyning, P creators_name: Nazareth, I creators_name: Exarchos, TP creators_name: Fotiadis, D creators_name: Koutsouris, D creators_name: Luxon, LM title: Diagnostic accuracy and usability of the EMBalance decision support system for vestibular disorders in primary care: proof of concept randomised controlled study results ispublished: inpress subjects: UCH divisions: UCL divisions: B02 divisions: C07 divisions: D06 divisions: D07 divisions: F84 divisions: D12 divisions: G20 keywords: Decision support system, Diagnosis, Dizziness, Randomised control trial note: Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. abstract: BACKGROUND: Dizziness and imbalance are common symptoms that are often inadequately diagnosed or managed, due to a lack of dedicated specialists. Decision Support Systems (DSS) may support first-line physicians to diagnose and manage these patients based on personalised data. AIM: To examine the diagnostic accuracy and application of the EMBalance DSS for diagnosis and management of common vestibular disorders in primary care. METHODS: Patients with persistent dizziness were recruited from primary care in Germany, Greece, Belgium and the UK and randomised to primary care clinicians assessing the patients with (+ DSS) versus assessment without (- DSS) the EMBalance DSS. Subsequently, specialists in neuro-otology/audiovestibular medicine performed clinical evaluation of each patient in a blinded way to provide the "gold standard" against which the + DSS, - DSS and the DSS as a standalone tool (i.e. without the final decision made by the clinician) were validated. RESULTS: One hundred ninety-four participants (age range 25-85, mean = 57.7, SD = 16.7 years) were assigned to the + DSS (N = 100) and to the - DSS group (N = 94). The diagnosis suggested by the + DSS primary care physician agreed with the expert diagnosis in 54%, compared to 41.5% of cases in the - DSS group (odds ratio 1.35). Similar positive trends were observed for management and further referral in the + DSS vs. the - DSS group. The standalone DSS had better diagnostic and management accuracy than the + DSS group. CONCLUSION: There were trends for improved vestibular diagnosis and management when using the EMBalance DSS. The tool requires further development to improve its diagnostic accuracy, but holds promise for timely and effective diagnosis and management of dizzy patients in primary care. TRIAL REGISTRATION NUMBER: NCT02704819 (clinicaltrials.gov). date: 2021-10-20 date_type: published official_url: https://doi.org/10.1007/s00415-021-10829-7 oa_status: green full_text_type: pub pmcid: PMC8527447 language: eng primo: open primo_central: open_green verified: verified_manual elements_id: 1896552 doi: 10.1007/s00415-021-10829-7 pii: 10.1007/s00415-021-10829-7 lyricists_name: Bamiou, Doris-Eva lyricists_name: Koohi, Nehzat lyricists_name: Nazareth, Irwin lyricists_id: DEBAM22 lyricists_id: NKOOH64 lyricists_id: IDNAZ80 actors_name: Dewerpe, Marie actors_id: MDDEW97 actors_role: owner full_text_status: public publication: Journal of Neurology event_location: Germany citation: Bamiou, D-E; Kikidis, D; Bibas, T; Koohi, N; Macdonald, N; Maurer, C; Wuyts, FL; ... Luxon, LM; + view all <#> Bamiou, D-E; Kikidis, D; Bibas, T; Koohi, N; Macdonald, N; Maurer, C; Wuyts, FL; Ihtijarevic, B; Celis, L; Mucci, V; Maes, L; Van Rompaey, V; Van de Heyning, P; Nazareth, I; Exarchos, TP; Fotiadis, D; Koutsouris, D; Luxon, LM; - view fewer <#> (2021) Diagnostic accuracy and usability of the EMBalance decision support system for vestibular disorders in primary care: proof of concept randomised controlled study results. Journal of Neurology 10.1007/s00415-021-10829-7 <https://doi.org/10.1007/s00415-021-10829-7>. (In press). Green open access document_url: https://discovery.ucl.ac.uk/id/eprint/10137404/3/Bamiou2021_Article_DiagnosticAccuracyAndUsability.pdf