Accuracy of the HINTS Exam for Vertigo in the Hands of Emergency Physicians

The lack of evidence to support performance of the HINTS exam by EPs does not prove we cannot use it successfully.

The HINTS (Head Impulse, Nystagmus, Test of Skew) exam has been shown to accurately identify central causes of vertigo when performed by neuro-ophthalmologists on patients with acute vestibular syndrome (Stroke 2009; 40:3504). To compare the accuracy of HINTS exams performed by emergency physicians (EPs) and neurologists for identifying central causes of vertigo, researchers performed a systematic review and meta-analysis. Inclusion criteria were adult patients with acute vestibular syndrome (constant vertigo, nystagmus, ataxia) evaluated with a HINTS exam performed by any clinician, with neuroimaging as the gold standard.

In the five studies identified, overall risk of bias was moderate. In most studies, HINTS exams were performed by neurol…

Reviewing Author

Benton R. Hunter, MD

Disclosures

Leadership Positions in Professional SocietiesSociety for Academic Emergency Medicine (Chair, Evidence Based Healthcare Interest Group)

Benton R. Hunter, MD

Disclosures

Leadership Positions in Professional SocietiesSociety for Academic Emergency Medicine (Chair, Evidence Based Healthcare Interest Group)

Accuracy of the HINTS Exam for Vertigo in the Hands of Emergency Physicians

Topics

Reviewing Author