AIVertigo: AIVertigo: Automated Differential Diagnosis of Vertigo Using Video-oculography and Advanced Artificial Intelligence-based Triage
Condition: Vertigo
MeSH terms: Vertigo; Dizziness
Study type: Observational

Summary: 
      The eye movement records and vestibular pulse examinations obtained from patients with
      dizziness can provide characteristic parameters and features of eye movements and vestibular
      reflexes. These can assist specialized physicians in diagnosing various forms of dizziness
      disorders. Through extensive analysis of databases, a disease prediction model can be
      established, significantly lowering the diagnostic barriers for non-specialist doctors,
      thereby enabling their diagnostic capabilities to approach that of experts.
    

Detailed description: 
      Investigators analyze the VOG and vHIT data of vertigo patients in the dizziness clinics of
      two medical institutions: Shuang Ho Hospital (SHH) between June 2020 and June 2021 and
      Taichung Tzu Chi Hospital (TTCH) between July 2019 and August 2020, respectively. The
      institutional review boards of SHH (TMU-JIRB No. N202005118) and TTCH (REC 109-64) approved
      the study. All patients received structuralized history taking, neurological examinations,
      neuro-otological examinations, VOG and vHIT. All patients who had focal neurological
      symptoms/signs or central vestibular/oculomotor signs underwent brain MRI. Final diagnoses
      were conducted after the comprehensive studies above. The patients who did not finish VOG
      tests or vHIT or who had invalid data in VOG or vHIT, as well as those with uncertain final
      diagnoses, were excluded from the study.

      According to the final diagnoses, all patients were further classified into "benign vertigo"
      and "dangerous vertigo" groups as the reference standard of this study. Benign vertigo is
      defined as vertigo that is not caused by any serious underlying condition and is generally
      considered harmless or self-limiting. It includes all peripheral-type vertigo and "benign"
      central-type vertigo without structural lesions in the brain, such as vestibular migraine and
      persistent postural-perceptual dizziness. However, dangerous vertigo is defined as the
      vertigo that is caused by a potentially severe or life-threatening underlying condition that
      requires immediate medical attention and intervention. It includes central-type vertigo with
      compatible structural lesions in the brain MRI, vertebrobasilar insufficiency with compatible
      stenotic arteries in MRI, and cerebellar degeneration with brain atrophy in MRI or apparent
      cerebellar ataxia. The classification of benign or dangerous vertigo was performed by two
      neurologists with expertise in dizziness and vertigo at each medical institution (SHH and
      TTCH) after they reviewed the clinical information and final diagnoses. In case they had
      differing opinions, they reached a consensus via video conferences. Otherwise, the clinical
      workflow was in accordance with the standard procedures of each medical institution.
    

Observational model: Cohort
Time perspective: Prospective
Sampling method: Probability Sample
Study population: 
        Patients with dizziness who seek treatment at the Neurology or Otolaryngology outpatient
        clinics or are admitted to Shuang Ho Hospital are potential candidates for enrollment.
        Patients who meet the inclusion criteria and have the research purpose and process
        explained by a physician or research assistant, agree to participate in this study, and
        complete the informed consent form will be considered eligible for enrollment.
      
Keywords: Vertigo; Videonystagmography (VNG); Software as Medical Device (SaMD); Computer-Aided Triage and Notification (CADt); Artificial Intelligence/Machine Learning (AI/ML)