[SCD programmatic diagnostic strategy and diagnostic pathway for vertigo disease]

Vertigo （or dizziness） is one of the most common symptoms in clinical practice. The misdiagnosis rate of vertigo diseases is high due to the factors that vertigo disorders involve multiple systems and organs throughout the body with a wide range of pathogenesis, and different kind of vertigo diseases often present with overlapping clinical presentation. In recent years, scholars have conducted many explorations in the diagnosis model of vertigo disorders, the identification model of high-risk central vertigo, or the combination of diagnostic tests such as the TiTrATE diagnostic model for vertigo disorders （Newman-Toker and Edlow, 2015）, the ATTEST differential diagnosis model for acute vertigo （Gurley and Edlow, 2019）; the application of the ABCD2 score to assess the risk of high-risk vertigo （Navi et al, 2012）, and the "TriAGe+" score to assess the risk of stroke in vertigo patients （Kuroda et al, 2017）; HINTS battery （Kattah et al, 2009）, HINTS+ battery （Newman-Toker et al, 2013）, and STANDING battery （Vanni et al, 2014） for acute serious vestibular disorders. These diagnostic approaches are immensely beneficial in enhancing the accuracy of vertigo diagnosis, as well as for identifying high-risk central vertigo with reducing the misdiagnosis of vertigo. Based on clinical experience, with referring to the diagnostic approaches mentioned above, the author propose the SCD programmatic diagnostic strategy for vertigo disorders[Strategy 1: Classification of vertigo syndromes （syndromes, S）; Strategy 2: Identify/diagnose high-risk central vertigo （central, C）; Strategy 3: differential diagnosis of peripheral vertigo （disease, D） ] and the A·E³GAP·AT differentiation battery and A²B²C²D²E³ alarm battery for dangerous central vertigo as well as targeted identifying and examining of E³GAP battery for central vertigo in five steps.The SCD programmatic diagnostic strategy for vertigo disorders is beneficial for clinicians to grasp diagnostic approach and pay special attention to dangerous central vertigo, while mastering the differential diagnosis model of dangerous central vertigo as well as the rapid diagnostic approach of peripheral vertigo.