US emergency departments see 4 million patients with dizziness or vertigo annually. The most common causes are benign inner ear problems, but some are dangerous strokes in the back part of the brain that controls balance. We now spend more than $9 billion on diagnostic workups, but still misclassify 80% of inner ear causes and miss 35% of strokes, resulting in thousands of preventable deaths and disabilities. Evidence-based methods, using rapid bedside eye-movement exams, distinguish strokes from inner-ear diseases with 99% accuracy. Unfortunately, these have not yet been widely adopted in routine emergency department practice. Implementing evidence-based diagnosis for dizziness nationwide could save thousands of lives and more than $1 billion annually. New devices that measure eye movements could facilitate dissemination of this new approach, fundamentally transforming diagnosis for dizziness in the emergency department.
Dr. David E. Newman-Toker is Associate Professor of Neurology and Otolaryngology at the Johns Hopkins University School of Medicine, with joint appointments in Health Sciences Informatics, Emergency Medicine and Epidemiology. His training is in Neurology, Neuro-ophthalmology, Neuro-otology, and Clinical Research Methods. Dr. Newman-Toker’s clinical interest is in diagnosis of acute disorders affecting the brainstem and cranial nerves, particularly stroke. His research mission is to achieve better outcomes through better diagnosis. His team’s work has focused on errors in diagnosis, test overuse, decision modeling, clinical algorithms, new diagnostic technologies, and decision support to reduce misdiagnosis and improve efficiency in frontline diagnosis. He has been the principal investigator for multiple NIH, AHRQ and foundation grants on these topics. He has published more than 50 peer-reviewed journal articles and given more than 100 invited lectures on diagnosing acute dizziness and diagnostic errors. His work has been recognized through membership in the Delta Omega Honorary Society in Public Health, the American Neurological Association, and the international Bárány Society.
Learn more about Dr. Newman-Toker
Watch Can New Tech Diagnose a Stroke?
A CBS This Morning news video with Dr. Newman-Toker about the stroke googles.
Newman-Toker Collection, NOVEL (Neuro-Ophthalmology Virtual Education Library)
A collection of articles and video clips on Dr. Newman-Tokers research.