Inter-rater agreement in the choice of prophylactic treatment for vestibular migraine and role of an assisted algorithm for this choice.
BACKGROUND AND OBJECTIVE
Vestibular migraine (VM) is a cause of episodic vestibular syndrome. There are many drugs available for its prophylaxis and currently the choice is mainly made according to the patient's comorbidities. The aim of this article was to measure the agreement of a group of otorhinolaryngologists in the choice of a prophylactic treatment and to evaluate the role of an assisted algorithm in the choice of this prophylaxis.


MATERIAL AND METHOD
The medical records of 10 patients with VM were offered to 10 otolaryngologists who were asked to select for each patient the drug they considered most appropriate among five possible options. The Fleiss' κ index was calculated among the 10 otolaryngologists alone, recalculating it including the algorithm as the eleventh evaluator, and Cohen's κ index was calculated between each otolaryngologist and the answers of the algorithm. The otolaryngologists were offered the option to change their responses after knowing the responses of the algorithm and then both indexes were calculated again.


RESULTS
The Fleiss' κ index was .302. This index was raised to .343 after introducing the algorithm as an evaluator. After offering the responses proposed by the algorithm, Cohen's κ was improved in 9 of the 10 evaluators, and Fleiss' κ rose to .711.


CONCLUSIONS
The agreement between otorhinolaryngologists in choosing prophylaxis for MV can be defined as "fair". The responses of the algorithm for the choice of prophylaxis were close to the average opinion of the otolaryngologists, raising the agreement between them to "substantial".
['Domínguez-Durán|Emilio|E|', 'Baños-López|Pablo|P|', 'Martín-Castillo|Elena|E|', 'Galera-Ruiz|Hugo|H|']
D000293:Adolescent D000328:Adult D000368:Aged D000465:Algorithms D000066491:Clinical Decision-Making D005260:Female D006801:Humans D008297:Male D008875:Middle Aged D008881:Migraine Disorders D015588:Observer Variation D010036:Otolaryngology D015837:Vestibular Diseases
Treatment Vestibular migraine Algorithms Prophylaxis Algoritmos Migraña vestibular Profilaxis Tratamiento