From diagnosis to daily life: Applying the DATA model in BPPV care
With increasing demand for efficient, accurate vestibular care, clinics need tools that turn complex measurements into confident decisions and faster patient outcomes.
This is especially true in the management of Benign Paroxysmal Positional Vertigo (BPPV), where small differences in head position, canal involvement, and eye movements can significantly affect diagnosis and treatment success.
Introducing the DATA model
The DATA model (Diagnose, Assess, Train, and (re-)Assess) offers a structured, data-driven approach to BPPV care that connects objective measurements to clinical decision-making at every step. By following this approach, clinicians can reduce misdiagnosis, avoid unnecessary or ineffective interventions, and confirm treatment success with confidence.
In this blog, we apply the DATA model to a common BPPV patient presentation, illustrating how precise head and body positioning, objective eye torsion tracking, and repositioning maneuvers performed with VNG goggles using the VORTEQ™ head sensor and TRV Chair enable accurate diagnosis and effective treatment.
Keep in mind, this approach supports coordinated, multidisciplinary care with multiple professionals working together, such as an audiologist, ENT physician, and/or physiotherapist.
BPPV case example
A patient comes into the clinic describing a sudden onset of intense room-spinning dizziness that occurs with positional changes such as getting out of bed, looking up into the kitchen cabinets, or bending down to pick something up off the ground.
Their spinning lasts for as long as they are in the triggering position and resolves between episodes. However, they do feel off-balance most of the time. These symptoms have reduced their participation in daily activities.
The patient went to their primary care provider who completed a Dix-Hallpike maneuver on them, but their symptoms were not provoked. The patient was sent home without a diagnosis and placed on symptom-relief medication.
A couple weeks later, the patient called their primary care provider, noting that symptoms were still present and impacting their ability to drive and go to work. The primary care provider referred them for comprehensive vestibular testing at a local audiologist’s office.
Diagnose and Assess
The gold standard approach for this patient would be to complete comprehensive vestibular testing to differentiate between central versus peripheral origin of dizziness. A complete vestibular workup would include:
- A comprehensive VNG test with calorics
- Use of the TRV Chair with the VORTEQ head sensor for positioning/positional testing
- vHIT, VEMP, and audiometric evaluation
After initial testing, this patient’s results for VNG, vHIT, VEMP, and caloric testing were normal. However, after completing the Advanced Dix-Hallpike and Lateral Head Roll tests in the TRV Chair, the patient had an abnormal result – indicating right posterior canal cupulothiasis BPPV.
Clinical value: When controlling head and body position by using the VORTEQ head sensor and TRV Chair, while measuring torsional eye movements, you can achieve greater diagnostic accuracy [1-2], and your patients are more likely to experience faster symptom resolution and a higher quality of care [3].
Train
Since BPPV is a very treatable vestibular disorder and the patient is already in the TRV Chair from testing, treatment is easy and safe. The patient undergoes a potentiated canalith repositioning maneuver in the TRV Chair. Because the sensor and goggles are on the patient and the patient is secure in the TRV Chair, all three components for a successful treatment are in place.
Operational value: Immediate treatment in the same setup reduces appointment time and improves clinic efficiency.
(re-)Assess
To confirm the successful treatment of the patient’s BPPV, Dix-Hallpike testing is repeated. Since the patient is still wearing the head sensor and video goggles and is secure in the TRV Chair, re-evaluation is easy and exact. No nystagmus is measured and the patient denies symptoms of dizziness or vertigo.
Outcome value: Instant verification of treatment minimizes repeat visits and increases patient confidence.
Why traditional testing and bedside treatment maneuvers are not always enough
Standard bedside positioning tests work well for some patients, but not all. Patients with limited neck or back mobility, high anxiety, or obesity can struggle with manual maneuvers.
Also, clinicians with mobility or strength concerns, limited table space for evaluation, or mismatches in patient versus clinician size can present challenges for safe and effective testing. In fact, research has shown that even the most experienced clinicians may not be achieving the proper testing or treatment positions for the involved semicircular canal [4].
In these cases, testing may be incomplete or inaccurate, delaying proper care.
Treating BPPV with manual maneuvers can also be especially challenging in:
- Recurrent BPPV
- Multi-canal involvement
- Patients who “don’t respond” to standard treatments
- Those who cannot lay flat on their back or have limited neck mobility
These limitations are not uncommon – and they represent a key reason why clinics are moving toward other options for safe treatment of BPPV, such as the TRV Chair.
The takeaway: Better diagnosis leads to improved outcomes
The DATA model allows for more efficient and comprehensive diagnosis so the patient’s treatment and training can be customized and individualized for their needs. This allows for a happier patient experience and reduced impact on the patient’s daily life.
For BPPV, the TRV Chair, VORTEQ head sensor, and VisualEyes™ VNG system create an integrated setup designed to support every step of the DATA model – from diagnosis to returning to daily life.
This approach doesn’t replace clinical expertise. It enhances it by combining clinical experience with evidence-based technology that supports precision and efficiency.
Want to implement this approach in your clinic?
Learn how to apply the DATA model step-by-step in our course:
References
[1] Hentze, M., Hougaard, D. D., & Kingma, H. (2025). Impact of head orientation and head movement in traditional manual diagnostics of benign paroxysmal positional vertigo: a randomized controlled crossover study. Frontiers in neurology, 16, 1654404.
[2] Hentze, M., Hougaard, D. D., & Kingma, H. (2024). Is diagnostics of Benign Paroxysmal Positional Vertigo with a mechanical rotation chair superior to traditional manual diagnostics? A randomized controlled crossover study. Frontiers in neurology, 15, 1519837.
[3] Soylemez, E., Bolat, K. B., Karakoc, K., Can, M., Basak, H., Aydogan, Z., & Tokgoz-Yilmaz, S. (2023). The Effect of Repositioning Maneuver Applied with the TRV Chair on Residual Dizziness after Benign Paroxysmal Positional Vertigo. Otology & neurotology : official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology, 44(8), e596–e601.
[4] Hentze, M., Hougaard, D. D., & Kingma, H. (2025). The Intra-Examiner Variability in and Accuracy of Traditional Manual Diagnostics of Benign Paroxysmal Positional Vertigo: A Prospective Observational Cohort Study. Journal of Clinical Medicine, 14(2), 434.
