Phillips, Mallinson and Hamid published a paper entitled "Cost-effective evaluation of the vestibular patient" (2011). They state "SUMMARY: Tests of vestibular function are expensive and their ability to diagnose specific vestibular pathologies is lacking. However, there are some tests that, when used in specific circumstances, may be very helpful in the diagnosis and management of patients with these complaints. " In the conclusion, they go on to say that "Contemporary vestibular testing is expensive, lacks accuracy, is operator dependent, and often has little effect on patient outcome. A thorough focussed clinical otoneurological history and examination plus a comprehensive pure tone audiogram, with the careful use of certain tests tailored according to history and examination, are key to optimally managing the vestibular patient".
So in other words, these authors suggest that it is best to depend on the "clinical impression", and prefer a low-budget approach to managing dizziness.
While we understand that ideally medical care should be highly efficient and low cost, practically most people would prefer that medical care be based on evidence, and prefer that the evidence be obtained through instruments that provide an "objective" measurement, as opposed to the conjectures of their physicians combined with a hearing test.
We also are of the opinion that progress in medicine will not be attained through relying on clinical impressions and audiograms, but rather will likely come through a combination of better understanding and better technology.