2018-19 TLTM Award Winners:
Alice Davis, Heather Campbell, Nicole Miranda
Rueckert-Hartman College for Health Professions
DizzyDx: A Web-based Clinical Tool to Guide the Differential Diagnosis of Dizziness
SummaryNicole Miranda, PT, DPT and Heather Campbell PT, DPT, MA have created a web-based application, “DizzyDx”, to facilitate clinical problem solving in the differential diagnosis and management of dizziness. Dizziness is a poorly defined term that can be associated with a variety of diagnoses, including but not limited to the following: concussion, mild traumatic brain injury, whiplash associated disorders, vestibular disorders, and central sensory processing disorders. The App assists the student or clinician in astute interviewing skills to obtain a refined subjective description of the symptom or associated symptoms. Effective interview and history taking direct specific selection of tests and measures, and helps rapidly identify the potential need for outside referrals and medical management of complications that could interfere with anticipated response to physical therapy interventions.
Once the term dizziness has been refined, the App prompts the student or clinician to consider variable hypotheses that could contribute to the sensation of dizziness, such as cervical, vestibular, or visual dysfunction, migraine activity or a combination of other associated factors. An information icon offers a citation of the best available current published literature to support the line of clinical thinking, and interest generated should stimulate further independent literature review. Once the App is fully functioning, literature references would be regularly updated as a service to student/clinician users.
A key principle of the learning module includes clinical reasoning that should be repeated at every clinical encounter. A condensed interview promotes proper analysis of response to intervention and prioritization of subjective symptoms on each day of service, increasing the likelihood of addressing physical therapy impairments in a systematic manner to provide improved response to physical therapy interventions.
The tool has been developed in WordPress on a template that is responsive for use on hand-held or laptop devices, and has largely been conceptualized via bootstrapping. The content is currently under review and editing, but the product requires IT guidance for completion to create a minimum viable product that could be used by Regis PT students as a beta test. In order to create a sustainable and useful product it is imperative to create an infrastructure to support future product development.