# Classifying and Comparing Diagnostic Strategies for Dizziness with a Claims-Based Analysis

> **NIH NIH R21** · UNIVERSITY OF MINNESOTA · 2020 · $154,000

## Abstract

Project Summary/Abstract
Dizziness is a debilitating and common presenting symptom that prompts substantial use of diagnostic health
services (i.e., tests and physician consults). The clinical utility of currently available strategies for evaluating
dizziness is unknown, leading to substantial practice variation. This study aims to characterize current patterns
of use of tests and specialist consults (i.e. diagnostic strategies) and to determine which strategies lead to
outcomes that indicate diagnostic value. The proposed research will be carried out with the OptumLabs Data
Warehouse (OLDW). OLDW is a large administrative database newly available to researchers that contains
claims for over 100 million commercially insured adults of working age (18-64 years old) and Medicare
Advantage members (≥ 65 years old) from across the U.S. Specifically, Aim 1 is to characterize variation in
diagnostic strategies used for evaluations of dizziness. The variety of diagnostic strategies currently used by
providers will be characterized by the choice, timing, and intensity of use of a.) diagnostic tests (audiometric,
vestibular, neuroimaging, cardiac tests) and, b.) specialist consults (otolaryngology, neurology, cardiology).
Patient- and provider-related factors associated with specific diagnostic strategies will be identified, and total
spending on each strategy will be estimated. Aim 2 is to evaluate the impact of diagnostic strategies for
dizziness on indicators of diagnostic value. Diagnostic strategies have value, according to rigorous evidence
framework, when there is evidence that they improve: a) diagnostic thinking; b) therapeutic actions; c) patient
outcomes; and, d) societal costs and benefits. The effects of various diagnostic strategies on outcomes that
reflect each value indicator will be assessed: a) subsequent diagnostic refinement; b) initiation of treatment; c)
fall-related injuries; and d) subsequent healthcare utilization for dizziness. This work represents a
multidisciplinary health services research approach to identifying effective and efficient diagnostic strategies for
dizziness. The proposed work will delineate the scope and consequences of variation in the way providers
approach dizziness evaluations and will identify key features of diagnostic strategies that optimize diagnostic
value for specific groups of patients and providers. These findings will lay the groundwork for future
comparative effectiveness trials and the development of best-practice protocols that translate evidence into
recommendations for clinical care for dizziness.

## Key facts

- **NIH application ID:** 9870913
- **Project number:** 5R21DC016359-03
- **Recipient organization:** UNIVERSITY OF MINNESOTA
- **Principal Investigator:** Meredith Evelyn Adams
- **Activity code:** R21 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $154,000
- **Award type:** 5
- **Project period:** 2018-03-01 → 2022-02-28

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9870913

## Citation

> US National Institutes of Health, RePORTER application 9870913, Classifying and Comparing Diagnostic Strategies for Dizziness with a Claims-Based Analysis (5R21DC016359-03). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/9870913. Licensed CC0.

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