Epidemiological Investigation and Cohort Study of Vestibular Disorders in China
Epidemiological Investigation and Cohort Study of Vestibular Disorders in China
The goal of this observational study is to characterize the clinical features, etiological distribution, and longitudinal outcomes of patients with dizziness and/or vertigo in real-world neurological and otolaryngological outpatient settings across China. The main questions it aims to answer are:
What is the etiological spectrum of dizziness and vertigo in patients presenting to neurology and otolaryngology clinics in China, and how do diagnoses evolve over time under routine clinical practice? Additionally, how do symptoms, functional impairment, and treatment responses change during follow-up?
Participants presenting with dizziness and/or vertigo who are already receiving routine clinical care at participating hospitals will be enrolled in a multicenter registry. They will undergo baseline clinical assessment and complete standardized questionnaires, and will be followed at predefined intervals for up to 12 months (with possible extended follow-up) through outpatient visits, electronic diaries, or telephone interviews to assess diagnostic stability, symptom progression, and treatment outcomes in a real-world setting.
Inclusion Criteria:
Exclusion Criteria:
This study is designed as a prospective, multicenter, real-world observational registry based on the Chinese Headache and Vertigo Registry System (CHRS), aiming to systematically characterize the etiological spectrum, diagnostic evolution, and clinical outcomes of patients presenting with dizziness and/or vertigo across neurology and otolaryngology outpatient settings in China. Participants will be consecutively or randomly enrolled from approximately 69 hospitals across more than 30 provinces, and all clinical data will be collected using standardized electronic case report forms within the CHRS platform. The registry integrates structured baseline assessments, including demographic characteristics, detailed clinical history, neurological and otological examinations, and standardized vestibular and audiological investigations, as well as validated patient-reported outcome measures. Etiological classification will be performed according to the Bárány Society International Classification of Vestibular Disorders consensus criteria, with supplementary classification based on ICD-11 when necessary. Longitudinal follow-up will be conducted at predefined time points up to 12 months, with extended follow-up allowed when clinically indicated, to evaluate diagnostic stability, symptom evolution, treatment response, and functional outcomes under routine clinical practice.
A comprehensive data management and quality assurance framework will be implemented. The CHRS registry will incorporate predefined data validation rules, including range checks, logical consistency checks, and cross-variable verification to ensure internal data integrity. Source data verification will be performed through periodic comparison of registry entries with medical records, imaging reports, and original clinical documentation at participating sites. A detailed data dictionary will be maintained, defining each variable, coding standards (including internationally recognized terminologies where applicable), and measurement scales. Standard Operating Procedures (SOPs) will govern all aspects of registry operations, including patient recruitment, informed consent, data entry, follow-up procedures, adverse event reporting, data monitoring, and protocol amendments. Site monitoring and auditing will be conducted periodically by independent reviewers to ensure protocol adherence and data accuracy.
Missing data will be managed according to predefined rules, including documentation of missingness mechanisms (e.g., unavailable, non-reported, or out-of-range values), and handled using appropriate statistical techniques such as multiple imputation or sensitivity analyses when applicable. Sample size determination is based on expected prevalence estimates and study precision requirements, with planned enrollment of approximately 6,000 participants to ensure adequate statistical power and representativeness. A detailed statistical analysis plan will be implemented, specifying descriptive analyses, comparative analyses, longitudinal modeling, and regression-based approaches to address primary and secondary objectives. All analyses will be conducted using validated statistical software, and results will be reported in accordance with relevant guidelines for observational registry studies.