Lost in the Labyrinth: Predicting Central Neurological Causes of Vertigo Dizziness and Unsteadiness in the Emergency Department. A Multicentre Cross-sectional Observational Study (VERTIGO)

This study will assess the sensitivity and specificity of the bedside examination algorithm performed by ED physicians. Finally, it aims to identify predictors of a central cause of the symptoms. This will consequently reduce the rate of misdiagnosis as well as the costs and length of stay due to inappropriate neuroimaging.

Study Overview

• Status: Recruiting
• Conditions: Dizziness; Unsteadiness; ED With Vertigo
• Intervention / Treatment: Diagnostic test: Bedside examination of Vertigo

• Study Type: Observational
• Enrollment (Estimated): 825

Contacts and Locations

• Study Contact: Name: Marco Bonzano, MD; Phone Number: +390382502039; Email: m.bonzano@smatteo.pv.it

Study Locations

• Italy
  • Pavia
    • Pavia, Pavia, Italy, 27100
      • Recruiting
      • SC Pronto Soccorso e Medicina d'Urgenza, Fondazione IRCCS Policlinico San Matteo
      • Contact: Marco Bonzano, MD; Phone Number: +390380502039; Email: m.bonzano@smatteo.pv.it

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: No

• Sampling Method: Non-Probability Sample

Study Population

Patients presenting at the ED with vertigo, dizziness or unsteadiness

Description

Inclusion Criteria:

• Patients presenting at the ED with vertigo, dizziness or unsteadiness
• >= 18 years of age
• Patients able to give their consent

Exclusion Criteria:

• Patients with dementia
• Bedridden patients (for causes other than the current symptoms)
• Patients with obvious neurological findings presenting with vertigo but with suspected stroke at triage

Study Plan

How is the study designed?

Number of groups / cohorts

1

Cohorts and Interventions

Group / Cohort	Intervention / Treatment
Patients presenting at the ED with vertigo, dizziness, and unsteadiness; Patients presenting to the ED with vertigo/ dizziness	Diagnostic test: Bedside examination of Vertigo; ED visit comprehensive of bedside examination of vertigo performed by trained EP or emergency medicine residents

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Time Frame
The AUC of the bedside examination algorithm performed by ED physicians	up to 36 months

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
identification of predictors of true positive patients	Predictors of true positive patients can help to stratify patients with vertigo for the risk of stroke.	up to 36 months
evaluation of number of neuroimaging tests (TC and angio-TC) performed to patients with vertigo in the ED.tests performed	to study the use of ED resources for these patients in terms of number of neuroimaging tests performed.	up to 36 months

Collaborators and Investigators

• Sponsor: Fondazione IRCCS Policlinico San Matteo di Pavia

Study record dates

Study Major Dates

• Study Start (Actual): January 26, 2024
• Primary Completion (Estimated): February 26, 2027
• Study Completion (Estimated): February 26, 2027

Study Registration Dates

• First Submitted: December 4, 2025
• First Submitted That Met QC Criteria: December 4, 2025
• First Posted (Actual): December 17, 2025

Study Record Updates

• Last Update Posted (Actual): December 17, 2025
• Last Update Submitted That Met QC Criteria: December 4, 2025
• Last Verified: February 1, 2025

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Neurologic Manifestations; Sensation Disorders; Pathological Conditions, Signs and Symptoms; Signs and Symptoms; Dizziness
• Other Study ID Numbers: VERTIGO

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No