A friend of mine named John had good luck using Microsoft's free online troubleshooting service for Vista:
"I am elated with the results of the Microsoft Automated Troubleshooting Services' Fix it. Have you ever run across this service? After 8+ months without a CD/DVD player—and weekly efforts to remedy the situation—I googled my problem once again and this time came up with a link to MATS.
"After several tries (not compatible with Firefox, open Internet Explorer, won't download, try again later) finally it loaded onto my computer and gave me some options to check off. Within 5 minutes, my CD/DVD was humming again."
Microsoft announced MATS last month. The service requires the PowerShell utility and uses an ActiveX control that it downloads to your system, so as my friend John noted, it works only with Internet Explorer. On the Operations Manager Support Team blog, Microsoft Manageability Knowledge Engineer J.C. Hornbeck outlines the troubleshooting steps MATS takes.
At present, there are only six automatic fixes offered by the service in three categories: "Appearance and personalization," "Hardware and sound," and "Print." You might think that's pretty slim pickings when you consider the range of PC problems, but if your PC's malady has been as thorny as my friend John's balky CD/DVD drive, MATS is worth a try.
Recently, my Vista notebook has been popping up an error message about not finding a Bluetooth driver when it boots. I don't use any Bluetooth devices, so I haven't worried about it. But I thought that was a good enough excuse to take MATS out for a test drive.
It took several minutes for the PowerShell and ActiveX control to download and install, after which I was presented with two options: identify and fix problems automatically, or detect them and let me decide what to fix.
I chose to detect but don't fix because I wasn't convinced there was really a problem. The only thing the scan came up with was the possibility that recent hardware changes hadn't been detected.
The resulting "Troubleshooting is complete" screen was ambiguous in this instance. It indicated that the issue of hardware changes not being detected was "Detected," according to the "Fix status." I assume that means the issue was detected, not the hardware changes themselves, but I'm not sure.
Before the troubleshooter closed, it offered three resources for further research into my problem: search Microsoft Answers communities, search Microsoft Help and Support, or open a Microsoft support request, which would send the test results to a "support professional." I chose to leave well enough alone.
I wouldn't hazard a guess at the odds of your particular Vista problem being addressed by one of MATS' automatic fixes, but running MATS beats a call to a "support professional" by a country mile.