{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,14]],"date-time":"2026-01-14T18:59:15Z","timestamp":1768417155398,"version":"3.49.0"},"reference-count":51,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2022,9,4]],"date-time":"2022-09-04T00:00:00Z","timestamp":1662249600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Academic Emergency Medicine"],"published-print":{"date-parts":[[2023,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>A short course of corticosteroids is among the management strategies considered by specialists for the treatment of vestibular neuritis (VN). We conducted an umbrella review (systematic review of systematic reviews) to summarize the evidence of corticosteroids use for the treatment of VN.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We included systematic reviews of randomized controlled trials (RCTs) and observational studies that evaluated the effects of corticosteroids compared to placebo or usual care in adult patients with acute VN. Titles, abstracts, and full texts were screened in duplicate. The quality of reviews was assessed with the A MeaSurement Tool to Assess systematic Reviews (AMSTAR\u20102) tool. The Grading of Recommendations, Assessment, Development and Evaluation (GRADE) assessment was used to rate certainty of evidence. No meta\u2010analysis was performed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>From 149 titles, five systematic reviews were selected for quality assessment, and two reviews were of higher methodological quality and were included. These two reviews included 12 individual studies and 660 patients with VN. In a meta\u2010analysis of two RCTs including a total of 50 patients, the use of corticosteroids (compared to placebo) was associated with higher complete caloric recovery (risk ratio 2.81, 95% confidence interval [CI] 1.32 to 6.00, low certainty). It is very uncertain whether this translates into clinical improvement as shown by the imprecise effect estimates for outcomes such as patient\u2010reported vertigo or patient\u2010reported dizziness disability. There was a wide CI for the outcome of dizziness handicap score (one study, 30 patients, 20.9 points in corticosteroids group vs. 15.8 points in placebo, mean difference\u2009+5.1, 95% CI \u22128.09 to +18.29, very low certainty). Higher rates of minor adverse effects for those receiving corticosteroids were reported, but the certainty in this evidence was very low.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>There is limited evidence to support the use of corticosteroids for the treatment of VN in the emergency department.<\/jats:p><\/jats:sec>","DOI":"10.1111\/acem.14583","type":"journal-article","created":{"date-parts":[[2022,8,17]],"date-time":"2022-08-17T08:48:23Z","timestamp":1660726103000},"page":"531-540","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Corticosteroids for patients with vestibular neuritis: An evidence synthesis for guidelines for reasonable and appropriate care in the emergency department"],"prefix":"10.1111","volume":"30","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5388-9163","authenticated-orcid":false,"given":"Lucas","family":"Oliveira J. e Silva","sequence":"first","affiliation":[{"name":"Department of Emergency Medicine Hospital de Clinics de Porto Alegre  Porto Alegre RS Brazil"},{"name":"Department of Emergency Medicine Mayo Clinic  Rochester Minnesota USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Danya","family":"Khoujah","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine University of Maryland School of Medicine  Baltimore Maryland USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"James G.","family":"Naples","sequence":"additional","affiliation":[{"name":"Division of Otolaryngology\u2010Head &amp; Neck Surgery, Beth Israel Deaconess Medical Center Harvard Medical School  Boston Massachusetts USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6855-0912","authenticated-orcid":false,"given":"Jonathan A.","family":"Edlow","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, Beth Israel Deaconess Medical Center Harvard Medical School  Boston Massachusetts USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Danielle J.","family":"Gerberi","sequence":"additional","affiliation":[{"name":"Mayo Clinic Libraries Mayo Clinic  Rochester Minnesota USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2603-7157","authenticated-orcid":false,"given":"Christopher R.","family":"Carpenter","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine Washington University at St. Louis  St. Louis Missouri USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1632-4750","authenticated-orcid":false,"given":"Fernanda","family":"Bellolio","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine Mayo Clinic  Rochester Minnesota USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2022,9,4]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMCP021154"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/J.OTC.2021.05.013"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1007\/S00415-010-5853-4"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.3389\/FNEUR.2016.00125"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/J.ANNEMERGMED.2017.10.012"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/J.JEMERMED.2017.12.024"},{"key":"e_1_2_9_8_1","unstructured":"Vestibular neuritis and labyrinthitis.UpToDate.2022. 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