The Development of the Dizziness Handicap Inventory (1990, Jacobson and Newman)
This foundational study describes the development of the Dizziness Handicap Inventory (DHI), a 25-item self-assessment tool designed to quantify the impact of dizziness in a patient’s daily life. Jacobson and Newman developed the DHI because, at the time, conventional vestibular tests could not adequately capture the functional, emotional, and physical consequences of dizziness. The 25 items are spread across these three domains: functional, emotional, and physical. The final version demonstrated good internal consistency and excellent test-retest reliability. At Dizzy Care Network, the DHI is integrated into our questionnaire to highlight how each care-seeker is experiencing dizziness. The DHI results are included in the clinician report to support comprehensive medical care.
Permanent Link: https://doi.org/10.1001/archotol.1990.01870040046011
Why is this research important for clinical practice?
The study established the DHI as a structured method for measuring how dizziness affects a patient beyond findings observed during vestibular testing. Objective measures may identify vestibular impairment, but they do not consistently reflect the degree to which symptoms affect an individual’s work, mobility, social participation, emotional health, or activity avoidance. The DHI gives patients a structured way to report their unique experiences.
During the study, Jacobson and Newman found no significant relationship between total DHI scores and caloric asymmetry, which exemplifies that everyone perceives and experiences dizziness differently. To further support this claim, the study found even though DHI scores increased with greater dizziness frequency, there was considerable variation within each frequency group. This highlights that every patient has a unique experience of dizziness, so diagnosis and treatment must be comprehensive.
Dizzy Care Network supports this approach by using structured patient-reported information to help clinicians review symptom history, functional impact, and care needs before the initial evaluation. You can access our redesigned DHI as an online version and a printable PDF version. Just scroll to the end of this page!
Key takeaways for Care Seekers
- The DHI measures how dizziness or unsteadiness affects your daily activities, emotions, and physical movements.
- Two people with similar vestibular test results may experience very different effects on their lives.
- The DHI does not identify the cause of the dizziness.
- The DHI may be repeated over time to help track whether your daily function is improving.
- The DHI does not replace a medical evaluation, physical examination, or vestibular testing.
Key takeaways for Clinicians
- The DHI is a 25-item patient-reported tool that can be used to measure how dizziness affects a patient’s daily life.
- Scores should be interpreted alongside the clinical history, physical examination, vestibular testing, functional assessment, and other relevant patient-reported measures.
- In the study, total DHI scores were not significantly related to caloric asymmetry, showing that clinical findings and self-reported disability measure different parts of the patient’s condition.
- The DHI can support treatment planning and outcome tracking, but it should not be used to diagnose the cause of dizziness.
Looking for an online version?
Our design team has made improvements to the visual design of the standard questionnaire and we are providing this free of charge. View the Online Dizziness Handicap Inventory which will calculate the score automagically as well as produce charts and a PDF you can download and share.
Looking for a printable PDF version?
Our design team has made improvements to the visual design of the standard questionnaire and we are providing this free of charge. This information is relevant for clinicians looking to improve their understanding of the impact that dizziness has had on your daily activities. Download the printable PDF version of the dizziness questionnaire.