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AAO35: Benign Positional Paroxysmal Vertigo (BPPV): Dix-Hallpike and Canalith Repositioning

AAO35: Benign Positional Paroxysmal Vertigo (BPPV): Dix-Hallpike and Canalith Repositioning

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High Priority: No; N/A
Percentage of patients with BPPV who had a Dix-Hallpike maneuver performed AND who had therapeutic canalith repositioning procedure (CRP) performed or who were referred for physical therapy or to a provider who can perform CRP if identified with posterior canal BPPV.

Denominator:
1. Patients diagnosed with BPPV.
2. Patients diagnosed with posterior canal BPPV.

Denominator Exclusions:
For Denominator 1: None
For Denominator 2 Only:

• Patients diagnosed with anterior or lateral BPPV.
• Patients with unspecified canal BPPV.

Denominator Exceptions:

• Patient has a history of BPPV, but is not currently experiencing positional dizziness/vertigo consistent with active BPPV.
• Patient has refused or declined Dix-Hallpike maneuver and/or CRP. (To be captured via search terms, this exclusion should be written as “patient refuses (or declines) Dix-Hallpike or CRP.”)
• Patient has cervical spinal disease (i.e., cervical stenosis, severe kyphoscoliosis, limited cervical range of motion, Down’s syndrome, severe rheumatoid arthritis, cervical radiculopathies, Paget’s disease, ankylosing spondylitis, low back dysfunction, spinal cord injuries, spinal fractures).
• Patient unable to lay flat (i.e., severe heart disease).
• Patient has severe atherosclerotic disease or recent dissection involving the anterior or posterior cerebral circulation.
• Unable to be seated in exam chair (i.e., morbidly obese), or maneuver cannot be safely performed given morbid obesity.

Numerator:
1. Patients who had a Dix-Hallpike maneuver performed.
2. Patients who had therapeutic CRP performed or were referred to a provider who can perform CRP, or were prescribed or referred for physical therapy.

Measure Classifications:

  • Measure Type: Process
  • National Quality Strategy (NQS) domain: Effective Clinical Care
  • Meaningful Measure Area: Appropriate Use of Healthcare
  • Calculation: 1st Performance Rate
    • Inverse measure: No
    • Continuous measure: No
    • Proportional measure: Yes
    • Ratio measure: No
    • Risk Adjusted measure: No
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