Department of Clinical Neurological Sciences, London Health Sciences Centre, Rm. C7-131, University Hospital, 339 Windermere Road, London, ON, N6A 5A5, Canada.
School of Kinesiology, Western University, London, ON, Canada.
Clin Auton Res. 2019 Feb;29(1):105-112. doi: 10.1007/s10286-018-0511-5. Epub 2018 Feb 28.
To develop a scale to quantify and discriminate orthostatic from non-orthostatic symptoms. In the current study, we present validation and reliability of orthostatic and non-orthostatic symptom scores taken from the orthostatic discriminate and severity scale (ODSS).
Validity and reliability were assessed in participants with and without orthostatic intolerance. Convergent validity was assessed by correlating symptoms scores with previously validated tools [autonomic symptom profile (ASP) and the orthostatic hypotension questionnaire (OHQ)]. Clinical validity was assessed by correlating scores against standardized autonomic testing. Test-retest reliability was calculated using an intra-class correlation coefficient.
Convergent validity: orthostatic (OS) and non-orthostatic (NS) symptom scores from 77 controls and 67 patients with orthostatic intolerance were highly correlated with both the orthostatic intolerance index of the ASP (OS: r = 0.903; NS: r = 0.651; p < 0.001) and the composite score of the OHQ: (OS: r = 0.800; NS: r = 0.574; p < 0.001). Clinical validity: symptom scores were significantly correlated with the total composite autonomic severity score (OS: r = 0.458; NS: r = 0.315; p < 0.001), and the systolic blood pressure change during head-up tilt (OS: r = - 0.445; NS: r = - 0.354; p < 0.001). In addition, patients with orthostatic intolerance had significantly higher symptom scores compared to controls (OS: 66.5 ± 18.1 vs. 17.4 ± 12.9; NS: 19.9 ± 11.3 vs. 10.2 ± 6.8; p < 0.001, respectively). Test-retest reliability: Both orthostatic and non-orthostatic symptom scores were highly reliable (OS: r = 0.956 and NS: r = 0.574, respectively; p < 0.001) with an internal consistency of 0.978 and 0.729, respectively.
Our initial results demonstrate that the ODSS is capable of producing valid and reliable orthostatic and non-orthostatic symptom scores. Further studies are ongoing to test sensitivity, specificity and symptom severity.
开发一种量表来量化和区分直立性和非直立性症状。在本研究中，我们提出了从直立性鉴别和严重程度量表（ODSS）中获得的直立性和非直立性症状评分的验证和可靠性。
在有和没有直立不耐受的参与者中评估了有效性和可靠性。通过与先前验证的工具[自主症状谱（ASP）和直立性低血压问卷（OHQ）]相关联来评估收敛效度。通过与标准化自主测试的相关性评估临床有效性。使用组内相关系数计算重测信度。
收敛效度：来自 77 名对照者和 67 名直立不耐受患者的直立性（OS）和非直立性（NS）症状评分与 ASP 的直立不耐受指数高度相关（OS：r=0.903；NS：r=0.651；p<0.001）和 OHQ 的综合评分（OS：r=0.800；NS：r=0.574；p<0.001）。临床有效性：症状评分与总自主严重程度评分显著相关（OS：r=0.458；NS：r=0.315；p<0.001），与头高位倾斜期间的收缩压变化显著相关（OS：r=-0.445；NS：r=-0.354；p<0.001）。此外，与对照组相比，直立不耐受患者的症状评分显著更高（OS：66.5±18.1 与 17.4±12.9；NS：19.9±11.3 与 10.2±6.8；p<0.001）。测试-重测信度：直立性和非直立性症状评分均高度可靠（OS：r=0.956 和 NS：r=0.574，分别；p<0.001），内部一致性分别为 0.978 和 0.729。
我们的初步结果表明，ODSS 能够产生有效的和可靠的直立性和非直立性症状评分。进一步的研究正在进行中，以测试敏感性、特异性和症状严重程度。
