Translation and Validation of the Dizziness Handicap Inventory into Thai Language

Translation and Validation of Dizziness Handicap Inventory in Hindi Language

The dizziness handicap inventory (DHI) is a widely used questionnaire for assessing the impact of dizziness on daily life. There is a need for validated translations of the DHI to accommodate diverse linguistic populations, enabling clinical and research comparisons. This study aimed to translate and validate the DHI into Hindi language. The DHI was translated into Hindi following established guidelines. The translated version underwent validation among Hindi-speaking patients presenting with dizziness at an outpatient ENT clinic in this cross-sectional study. Reliability and validity analyses were conducted, including Cronbach's alpha, split-half reliability, and factor analysis. A total of 153 participants completed the DHI-Hindi, with a mean score of 37.28 (SD = 15.63). Ceiling and floor effects were absent. The Cronbach's alpha coefficient for the overall scale was 0.785, indicating good reliability. Factor analysis revealed a three-factor solution, consistent with previous studies, indicating good construct validity.The translation and validation process yielded a reliable and valid version of the DHI in Hindi language, suitable for assessing the impact of dizziness in Hindi-speaking population.

Variability in Minimal Clinically Important Difference Calculation and Reporting in the Otolaryngology Literature

OBJECTIVE

Best practices for calculation of the minimal clinically important difference (MCID) of outcome measures include the use of complementary methodologies (broadly classified as anchor-based and distribution-based) and reporting of the MCID's predictive ability. We sought to determine MCID calculation and reporting patterns within the otolaryngology literature.

METHODS

A systematic search strategy of Embase, PubMed, and Web of Science databases was developed and implemented to identify studies reporting the determination of an MCID for an outcome measure. Studies specifically within the otolaryngology literature (defined as journals classified as "otorhinolaryngology" in the Journal Citation Reports database) were included. All those journals were additionally searched for relevant articles.

RESULTS

There were 35 articles that met the inclusion criteria. Of these studies, 88.6% reported MCID of a patient-reported outcome measure and the remainder were for objective outcome measurements. Anchor-based methods were used by 82.9% of studies and distribution-based methods were used by 68.6% of studies. Of all studies, 31.4% utilized anchor-based methods alone, 17.1% utilized distribution-based methods alone, and 51.4% used both methods. Only 25.7% of studies reported the sensitivity (median: 60.8%, range: 40.5%-86.7%) and specificity (median: 80.4%, range: 63.5%-88.0%) of the MCID to detect patients experiencing clinically important change.

CONCLUSION

Deviation from best practices in MCID calculation and reporting exists within the otolaryngology literature, with almost half of all studies only using one method of MCID calculation and almost three-quarters not reporting the predictive ability (sensitivity/specificity) of the calculated MCID. When predictive ability is reported, however, MCIDs appear to be more specific than sensitive.

LEVEL OF EVIDENCE

NA Laryngoscope, 134:2059-2069, 2024.

Psychometric Properties of the Persian Dizziness Handicap Inventory - Screening Version

OBJECTIVES

The Dizziness Handicap Inventory (DHI) is the most popular and widely used questionnaire in evaluating patients with vertigo. This questionnaire has a screening version with a high correlation with DHI. This study aimed to assess the psychometric properties of the Persian DHI - Screening version (DHI-S).

METHODS

This cross-sectional and methodological study was conducted on 300 patients at the central vestibular clinic in Mashhad, Iran, from 2020 to 2021. First, the DHI-S was translated into Persian using the backward-forward translation method. Subsequently, the following types of validity and reliability were examined: content validity based on content validity index and content validity ratio, face validity based on impact score, construct validity based on confirmatory factor analysis, internal consistency based on Cronbach's α and Ω, and test-retest stability based on intraclass correlation coefficient and smallest detectable change.

RESULTS

The DHI-S had high content and face validity. Score 8 was selected for the cutoff point between patients and the normal group with a sensitivity of 63.67% and specificity of 96.08%. The construct validity indicated that the questionnaire is one-dimensional. The Cronbach's α and Ω for internal consistency were 0.855 and 0.851, respectively. The intraclass correlation coefficient was 0.981 and the smallest detectable change was 5.521.

CONCLUSIONS

The DHI-S in the Persian language has high and acceptable psychometric properties. This questionnaire can be used in research and clinical settings.

Anterior cervical discectomy and fusion to treat cervical instability with vertigo and dizziness: A single center, retrospective, observational study

Purpose

The current study attempts to investigate the role of anterior cervical discectomy and fusion (ACDF) in alleviating symptoms in patients with cervical vertigo associated with cervical instability.

Methods

The patients of cervical instability with vertigo and dizziness who underwent ACDF between January 2011 and December 2019 were followed-up for more than two years. Demographic data (age, sex, follow up period and levels of instable cervical segments) were assessed; Symptoms of vertigo and dizziness before and after surgery were assessed by the 15-item version of the Vertigo Symptom Scale (VSS) and the 25-item Dizziness Handicap Inventory (DHI). The severity and frequency of other symptoms like neck and occipital pain, gastrointestinal discomfort, nausea, vomiting, tinnitus, palpitations, headache, diplopia and blurring of vision before and after surgery were also assessed.

Results

A total of 92 patients underwent ACDF for cervical instability with vertigo and dizziness between January 2011 and December 2019, of which 79 patients were included in the final analysis. The number of instable levels had no correlation with VSS and DHI scores before surgery (p > 0.05), while patients with C3/4 instability suffering a severer vertigo than other levels. Both DHI and VSS scores were significantly reduced after ACDF and this was sustained within two years after surgery (p < 0.001). Although there was no statistical difference in the ratio of patients with vertigo relief, patients with one-level cervical instability demonstrated a more rapid recovery than patients with multi-level cervical instability (p = 0.048). Also, there was improvement in other symptoms such as neck and occipital pain, gastrointestinal discomfort, nausea, vomiting, tinnitus, palpitations, headache and blurring of vision after surgery.

Conclusions

Vertigo caused by C3/4 instability was severer than other levels such as C4/5 and C5/6. During 2 years' follow-up the significant relief of vertigo and dizziness was observed after anterior cervical surgery. Other accompanying symptoms except hypomnesia were also extenuated in follow-up period.