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Benign Paroxysmal Positional Vertigo

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Disclaimer is Guideline attempts to define principles of practice that should produce high-quality patient care. It is applicable to specialists, primary care, and providers at all levels. is Guideline should not be considered exclusive of other methods of care reasonably directed at obtaining the same results. e ultimate judgment concerning the propriety of any course of conduct must be made by the clinician aer consideration of each individual patient situation. Neither IGC, the medical associations, nor the authors endorse any product or service associated with the distributor of this clinical reference tool. Abbreviations BLT, bow and lean test; BPPV, benign paroxysmal positional vertigo; CRP, canalith repositioning procedure; TIA, transient ischemic attack Source Bhattacharyya N, Gubbels SP, Schwartz SR, et al; Clinical Practice Guideline: Benign Paroxysmal Positional Vertigo (Update). Otolaryngol Head Neck Surg. 2017; 156(3_ suppl):s1-s47. 106 Commerce Street, Suite 105 Lake Mary, FL 32746 TEL: 407.878.7606 • FAX: 407.878.7611 Order additional copies at www.GuidelineCentral.com Copyright © 2017 All rights reserved AAOHNSBPPV1723 Aggregate Grades of Evidence by Question Type Grade Treatment Diagnosis Prognosis A Systematic review a of randomized trials Systematic review a of cross-sectional studies with consistently applied reference standard and blinding Systematic review a of inception cohort studies b B Randomized trials, or observational studies with dramatic effects or highly consistent evidence Cross-sectional studies with consistently applied reference standard and blinding Inception cohort studies b C Non-randomized or historically controlled studies, including case-control and observational studies Non-consecutive studies, case-control studies, or studies with poor, non-independent, or inconsistently applied reference standards Cohort study, control arm of a randomized trial, case series, or case-control studies; poor quality prognostic cohort study D Case reports, mechanism-based reasoning, or reasoning from first principles X Exceptional situations where validating studies cannot be performed and there is a clear preponderance of benefit over harm a A systematic review may be downgraded to level B because of study limitations, heterogeneity, or imprecision b A group of individuals identified for subsequent study at an early, uniform point in the course of the specified health condition, or before the condition develops

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