The 25-item Dizziness Handicap Inventory was shortened for use in general practice by 60 percent

• Published in: Journal of clinical epidemiology Vol. 126; pp. 56 - 64
• Main Authors: van Vugt, Vincent A., de Vet, Henrica C.W., van der Wouden, Johannes C., van Weert, Henk C.P. M., van der Horst, Henriëtte E., Maarsingh, Otto R.
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01-10-2020; Elsevier Limited
• Subjects: Aged; Aged, 80 and over; Clinical medicine; Correlation coefficient; Correlation coefficients; Criteria; Disability Evaluation; Dizziness; Dizziness - diagnosis; Dizziness - psychology; Dizziness Handicap Inventory; Female; General practice; General Practice - standards; General Practice - statistics & numerical data; Humans; Impairment; Male; Patients; Primary care; Prospective Studies; Psychometrics - methods; Questionnaires; Reliability analysis; Reproducibility of Results; ROC Curve; Surveys and Questionnaires; Validity; Vertigo; Vestibular Diseases - diagnosis; Vestibular Diseases - psychology; Vestibular system; Dizziness; Dizziness Handicap Inventory; General practice; Primary care; Vertigo
• ISSN: 0895-4356; 1878-5921
• DOI: 10.1016/j.jclinepi.2020.06.021

The 25-item Dizziness Handicap Inventory (DHI) is the most used questionnaire to assess vestibular symptoms. However, the abbreviated 10-item DHI-S is more suitable for daily practice. The objective of this study was to assess validity, reliability, responsiveness, optimal cutoff point for substantial impairment, and minimally important change (MIC) of the DHI-S in general practice.
We performed a psychometric questionnaire evaluation in general practice. In a prospective cohort study, 415 adults with vestibular symptoms filled out the DHI at baseline, and 1-week, 6-month, and 10-year follow-up. DHI answers were used to calculate DHI-S scores. We assessed validity by criterion validity (Pearson's r) at each measurement. We used longitudinal measurements for test–retest reliability (intraclass correlation coefficient (ICC)) and responsiveness (r). We determined optimal DHI-S cutoff points for substantial impairment (≥30 DHI) and MIC (>11 DHI) with receiver operating characteristic (ROC) curve analyses.
DHI-S demonstrated excellent criterion validity (r = 0.93–0.96), test–retest reliability (ICC = 0.86), and responsiveness (r = 0.89). DHI-S reliably distinguished substantial impairment and identified MIC, with optimal DHI-S cutoff scores of ≥12 points and >5 points, respectively.
The DHI-S is a valid, reliable, and responsive questionnaire that could replace the DHI in general practice.