To evaluate refractory BPPV based on the number of CRP attempts and investigate clinical factors associated with treatment resistance, with a focus on serum 25(OH)D levels and BPPV subtype.
Key Findings:
27.5% of patients required three or more CRP attempts, defining them as refractory BPPV.
BPPV subtype and prior vestibular neuritis were strong predictors of treatment resistance.
Lower serum 25(OH)D levels were associated with refractoriness, particularly in typical BPPV.
Interpretation:
Limitations:
Study design is retrospective, which may introduce bias, affecting the reliability of the findings.
Exclusion of patients with central lesions limits generalizability.
A VHA study across 11 vendors finds AI-generated primary care notes score lower than clinician-written notes, with the largest deficits in thoroughness, organization, and usefulness
