Color‐Bar Bedsheet: Affordable Assistive Tool for Dix‐Hallpike Test in Primary Care

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ABSTRACT Background Benign paroxysmal positional vertigo (BPPV) is a common cause of vertigo encountered in general practice. The definitive diagnosis relies on the Dix‐Hallpike test (DHT), which remains underperformed in primary care due to limited training and unfamiliarity among general practitioners. Aim To develop the color‐bar bedsheet as a simple visual positioning guide for DHT and demonstrate its usefulness. Design and Setting After the color‐bar bedsheet was developed, a prospective within‐subject comparative design in healthy participants was conducted. Methods Healthy adult subjects with 141–190 cm height were recruited. Each examiner performed the DHT with and without bedsheet. The proportion of the appropriate position and the satisfaction of subjects and examiners were compared. Results Sixty subjects and 12 examiners were enrolled. Subjects' average age was 37.8 ± 15.0 years and average BMI was 22.5 ± 3.6 kg/m 2 . The DHT with the bedsheet showed significantly better appropriate positions when compared to the group without using the bedsheet (65% vs. 18.33%, p < 0.001), with the odds ratios (OR) of 8.27. Also, there was significantly higher satisfaction of subjects and examiners in DHT with the bedsheet, compared to DHT without the bedsheet ( p < 0.001). Conclusions The DHT with the color‐bar bedsheet provided an 8 times higher chance of appropriate position (particularly in individuals under 170 cm in height) with better satisfaction of both examiners and subjects. The bedsheet could be used as an assistive tool for the DHT, especially for novice examiners, in order to increase the diagnostic yield of BPPV in primary care settings.

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