Summary

Computerised rotating chairs provide an additional means of diagnosing abnormalities of the vestibular system of the body.

Three hospitals are currently using rotating chairs for routine clinical testing in Australia. Additional installations are likely in the near future.

Rotational testing can add significantly to the diagnostic information available from existing tests of vestibular function, but would not replace them.

There is still uncertainty as to what would be an optimum test protocol using the technology. Sinusoidal rotation at different frequencies is most commonly used but the impulsive testing procedure is preferred by some workers in this area.

There is evidence to indicate that use of rotating chairs has a useful role in patient management, but as yet their contribution cannot be quantified.

Rotating chairs should be used only in the context of a full vestibular testing program. They should not be used for the indiscriminate testing of patients suffering from dizziness.

A patient throughput of 2 to 3 per day per chair seems feasible, with an all up cost per test in the region of $160-180. If rotating chair procedures were used for all persons requiring vestibular function testing (about 7 500 p.a.), the additional cost would be in the region of $1.2M - 1.4M p.a.

The Panel considers that reimbursement for clinical use of this technology is appropriate, but on a restricted basis until further details become available on test protocols, effects on patient management and costs.

The Panel recommends that:

  • At this stage computerised rotating chairs for clinical use should be restricted to major centres which are fully equipped for audiological and vestibular testing, and have appropriate expertise.
  • Consideration should be given to providing reimbursement to these facilities to cover professional and recurrent costs associated with the use of this technology for patients undergoing vestibular function testing.
  • Hospitals at present equipped with rotating chairs should be asked to provide reports to the NHTAP on their clinical performance at the end of 1987. These reports could provide a basis for recommendations on whether the technology should be more widely used.