{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,21]],"date-time":"2026-10-21T14:59:48Z","timestamp":1792594788761,"version":"4.5.0"},"reference-count":29,"publisher":"Wiley","license":[{"start":{"date-parts":[[2025,3,11]],"date-time":"2025-03-11T00:00:00Z","timestamp":1741651200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100011251","name":"Northern Ontario Academic Medicine Association","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100011251","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Academic Emergency Medicine"],"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>In 2022, nearly 0.5 million Canadians visited an emergency department (ED) for dizziness, accounting for over 3.5% of all ED visits. Of these patients, only 2%\u20135% received a serious diagnosis. The cost of ED and inpatient care for dizziness in Canada exceeds $200 million per year, of which neuroimaging accounts for a large proportion. Over one\u2010third of dizziness patients undergo a CT scan of the head, 96% of which are negative. Despite extensive investigation, patients discharged with a benign dizziness diagnosis have a 50\u2010fold increased risk of being admitted to the hospital within 7\u2009days with a diagnosis of stroke. Our study aimed to derive a clinical risk score to guide the investigation and referral for serious causes of vertigo in ED patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This multicenter historical cohort study was conducted over 7\u2009years at three university\u2010affiliated tertiary care EDs. Patients presenting with vertigo, dizziness, or imbalance were recruited. The main outcome was an adjudicated serious diagnosis, defined as stroke, transient ischemic attack, vertebral artery dissection, or brain tumor. We estimated a sample size of 4450 patients, based on a 2% prevalence of serious outcomes, to evaluate the sensitivity with 95% confidence intervals (CIs).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 4559 patients were enrolled (mean age 78.1\u2009years, 57.8% women), with serious events occurring in 104 (2.3%) patients. The C\u2010statistic was 0.95 (95% CI 0.92\u20130.98). The risk of a serious diagnosis ranged from 0% for a score of &lt;5 to 16.7% for a score &gt;8. Sensitivity for a serious diagnosis was 100% (95% CI 96.5%\u2013100%) and specificity was 69.2% (95% CI 67.8%\u201370.51%) for a score &lt;5.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The Sudbury Vertigo Risk Score effectively identifies the risk of a serious diagnosis in patients with dizziness. Thus, it guides further investigation, consultation, and treatment decisions and ultimately improves resource utilization and reduces missed diagnoses.<\/jats:p><\/jats:sec>","DOI":"10.1111\/acem.70017","type":"journal-article","created":{"date-parts":[[2025,3,12]],"date-time":"2025-03-12T09:15:54Z","timestamp":1741770954000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Validation of the <scp>Sudbury Vertigo Risk Score<\/scp> to risk stratify for a serious cause of vertigo"],"prefix":"10.1111","author":[{"given":"Elliot Tissot","family":"van Patot","sequence":"first","affiliation":[{"name":"Medical Sciences Program, Faculties of Medicine and Science University of Dalhousie  Halifax Nova Scotia Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Danielle","family":"Roy","sequence":"additional","affiliation":[{"name":"School of Epidemiology and Public Health, Faculty of Medicine University of Ottawa  Ottawa Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-9065-3470","authenticated-orcid":false,"given":"Elger","family":"Baraku","sequence":"additional","affiliation":[{"name":"The Faculty of Medicine University of Ottawa  Ottawa Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kashyap","family":"Patel","sequence":"additional","affiliation":[{"name":"The Faculty of Medicine University of Ottawa  Ottawa Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah","family":"McIsaac","sequence":"additional","affiliation":[{"name":"Department of Critical Care, Department of Anesthesia Northern Ontario School of Medicine  Sudbury Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ravinder","family":"Singh","sequence":"additional","affiliation":[{"name":"The Department of Neurology, Health Sciences North Health Sciences North Research Institute, Northern Ontario School of Medicine  Sudbury Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel","family":"Lelli","sequence":"additional","affiliation":[{"name":"Department of Neurology and Otolaryngology University of Ottawa and Ottawa Hospital Research Institute  Ottawa Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Darren","family":"Tse","sequence":"additional","affiliation":[{"name":"Department of Neurology and Otolaryngology University of Ottawa and Ottawa Hospital Research Institute  Ottawa Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Johns","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine University of Ottawa and Ottawa Hospital Research Institute  Ottawa Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1547-4634","authenticated-orcid":false,"given":"Krishan","family":"Yadav","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine University of Ottawa and Ottawa Hospital Research Institute  Ottawa Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David W.","family":"Savage","sequence":"additional","affiliation":[{"name":"The Department of Emergency Medicine Northern Ontario School of Medicine  Thunder Bay Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeffrey J.","family":"Perry","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine University of Ottawa and Ottawa Hospital Research Institute  Ottawa Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8263-0556","authenticated-orcid":false,"given":"Robert","family":"Ohle","sequence":"additional","affiliation":[{"name":"The Department of Emergency Medicine Health Sciences North, Health Sciences North Research Institute, Northern Ontario School of Medicine  Sudbury Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,3,11]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.otohns.2008.08.022"},{"key":"e_1_2_11_3_1","volume-title":"Clinical Methods: The History, Physical, and Laboratory Examinations","author":"Konrad HR","year":"2011"},{"key":"e_1_2_11_4_1","unstructured":"Guideline for Reasonable and Appropriate Care in the Emergency Department. 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