Cost-effective management of benign positional vertigo using canalith repositioning

OBJECTIVE The misdiagnosis and inappropriate treatment of benign positional vertigo have resulted in significant costs to the medical system. In the current medical-economic climate, there is an increased emphasis on cost control. Recent studies have shown that the canalith repositioning procedure (CRP) is effective; the next step is to show the impact of CRP in cost-effective management of benign positional vertigo. METHODS Forty-six of 100 patients who underwent CRP for benign positional vertigo responded to a survey regarding the financial impact of their disease. They were asked to subjectively estimate the sum of all disease-related expenses. Objective substantiation of this number was estimated by tabulating physician data, laboratory data, and failed treatment costs. RESULTS The subjective figure totaled $2684.74 per individual. Summation of the tangible objective figures yielded $2009.63 per patient, corroborating the subjective figure. CONCLUSIONS Because CRP is a relatively simple procedure that can obviate many wasted expenses in most patients, we believe that it is very cost-effective and should be incorporated into routine practice.

Cost-Effective Management of bEnign Positional Vertigo Using Canalith Repositioning

OBJECTIVE: The misdiagnosis and inappropriate treatment of benign positional vertigo have resulted in significant costs to the medical system. In the current medical-economic climate, there is an increased emphasis on cost control. Recent studies have shown that the canalith repositioning procedure (CRP) is effective; the next step is to show the impact of CRP in cost-effective management of benign positional vertigo. METHODS: Forty-six of 100 patients who underwent CRP for benign positional vertigo responded to a survey regarding the financial impact of their disease. They were asked to subjectively estimate the sum of all disease-related expenses. Objective substantiation of this number was estimated by tabulating physician data, laboratory data, and failed treatment costs. RESULTS: The subjective figure totaled $2684.74 per individual. Summation of the tangible objective figures yielded $2009.63 per patient, corroborating the subjective figure. CONCLUSIONS: Because CRP is a relatively simple procedure that can obviate many wasted expenses in most patients, we believe that it is very cost-effective and should be incorporated into routine practice.

Dependence of Apparent Movement of a Subjective Figure on the Perceptual Fate of Inducing Elements

In a series of demonstrations, two stimulus frames that contained subjective figures were alternated. It is shown that the perception of apparent movement of a subjective figure depends upon the configuration of the inducing stimuli and whether or not conditions of presentation favor the short-range or long-range process in apparent movement. Those conditions that favor the long-range process result in global apparent movement of the subjective figure. However, those conditions that favor the short-range process may prevent apparent movement of the subjective figure, or may result in a kind of apparent movement that is qualitatively different from that seen when similar physical contours are alternated. These results are interpreted in terms of the assumed differences between the short-range and long-range processes.

Subjective Contours Can Produce Stereokinetic Effects

When a pattern of interrupted concentric circles drawn so as to produce an anomalous contour ellipse is slowly rotated in the frontoparallel plane, the subjective figure appears first to deform and then to tilt as a ring in 3-D space over motionless circles. Also, Benussi's floating cone can be obtained by placing an eccentric gray dot upon an anomalous solid ellipse and setting this figure into rotation. These patterns provide strong evidence that subjective contours can produce stereokinetic effects as effectively as real contours can. Implications for current explanations of stereokinetic effects are presented and discussed.

Apparent Movement of Successively Generated Subjective Figures

In the present studies a pair of random-dot frames was constructed so that two areas in the first frame (f1) were correlated with two areas in the second frame (f2). The alternation of the pair of frames (an f1-f2 sequence) gave rise to two subjective figures. When two pairs of random-dot frames (an f1-f2 sequence and an f3-f4 sequence), each of which produced two subjective figures in different locations, were themselves alternated, the subjective figures from the f1-f2 sequence interacted with the subjective figures from the f3-f4 sequence to produce apparent movement. With any one of the four general kinds of displays which we constructed, subjects usually perceived only one of two types of subjective-figure movement. The type of movement that was perceived with a given display depended primarily upon the degree of change (across the interval between an f1-f2 and an f3-f4 sequence) of the internal structure of the successively generated subjective figures. Relative intensity differences between the subjective figures and their backgrounds influenced the type of apparent movement seen, whereas variations in the density of elements in a display did not. We tentatively propose a two-stage model to explain the apparent movement of the subjective figures: the first stage is assumed to generate the subjective figures by means of a cross-correlation of the intensity distributions of the two frames within an f1-f2 sequence and within an f3-f4 sequence; on the basis of inputs from the first stage, the second stage generates apparent movement signals for the subjective figures.