Filosa James, Omland Petter Moe, Hagen Knut, Langsrud Knut, Brenner Eiliv, Knutsen Andreas Jarlalein, Drange Ole Kristian, Bruvik Gravdahl Gøril, Stjern Marit, Engstrøm Morten, Sand Trond
Department of Neuroscience, Norwegian University of Science and Technology, Trondheim, Norway.
Department of Neurology and Clinical Neurophysiology, St. Olav's University Hospital, Trondheim, Norway.
J Sleep Res. 2022 Oct;31(5):e13571. doi: 10.1111/jsr.13571. Epub 2022 Mar 6.
Questionnaires for restless legs syndrome have rarely been validated against face-to-face interviews in the general population. We aimed to validate the modified Norwegian, seven-item Cambridge-Hopkins restless legs syndrome questionnaire and a single diagnostic question for restless legs syndrome. We also aimed to stratify validity at 65 years of age. Among a random sample of 1,201 participants from the fourth wave of the Trøndelag Health Study, 232 (19%) agreed to participate, out of whom 221 had complete data for analyses. Participants completed the questionnaires for restless legs syndrome immediately before attending a face-to-face interview using the latest diagnostic criteria. We calculated sensitivity, specificity, and Cohen's kappa statistic (κ) of questionnaire- versus interview-based diagnoses. We found acceptable validity of the seven-item modified Cambridge-Hopkins diagnostic questionnaire for restless legs syndrome (κ = 0.37, 95% confidence interval [CI] 0.23-0.51) and good validity of the single diagnostic question (κ = 0.47, 95% CI 0.35-0.58). We also found good validity through the combination of modified Cambridge-Hopkins diagnostic questionnaire for restless legs syndrome items 2 and 5, while item 1 or 2 alone showed only acceptable validity. The single diagnostic question was significantly more valid among those aged <65 years (κ = 0.60 versus κ = 0.26). Both single- and two-item questionnaire-based diagnoses overestimated interview-based restless legs syndrome prevalence. The seven-item modified Cambridge-Hopkins diagnostic questionnaire for restless legs syndrome will be useful for epidemiological studies although low sensitivity may cause underestimation of true restless legs syndrome prevalence in the general population, especially among elderly. Brief questionnaire-based diagnoses of up to three items seem best utilised as an initial screen. Future studies should identify brief and even more valid questionnaire-based diagnoses for restless legs syndrome in order to estimate prevalence accurately in large epidemiological studies.
针对不安腿综合征的问卷很少在普通人群中与面对面访谈进行过验证。我们旨在验证改良的挪威七项剑桥 - 霍普金斯不安腿综合征问卷以及一个不安腿综合征单项诊断问题。我们还旨在按65岁分层验证效度。在特隆赫姆健康研究第四轮的1201名参与者随机样本中，232人（19%）同意参与，其中221人有完整数据用于分析。参与者在使用最新诊断标准进行面对面访谈之前，立即完成了不安腿综合征问卷。我们计算了基于问卷与基于访谈的诊断的敏感性、特异性和科恩kappa统计量（κ）。我们发现七项改良剑桥 - 霍普金斯不安腿综合征诊断问卷具有可接受的效度（κ = 0.37，95%置信区间[CI] 0.23 - 0.51），单项诊断问题具有良好的效度（κ = 0.47，95% CI 0.35 - 0.58）。我们还发现，将改良剑桥 - 霍普金斯不安腿综合征诊断问卷的第2项和第5项结合起来具有良好的效度，而单独的第1项或第2项仅具有可接受的效度。单项诊断问题在年龄<65岁的人群中效度显著更高（κ = 0.60对比κ = 0.26）。基于单项和两项问卷的诊断均高估了基于访谈的不安腿综合征患病率。七项改良剑桥 - 霍普金斯不安腿综合征诊断问卷对于流行病学研究将是有用的，尽管低敏感性可能导致低估普通人群中真正的不安腿综合征患病率，尤其是在老年人中。基于问卷的最多三项的简短诊断似乎最适合用作初步筛查。未来的研究应确定针对不安腿综合征的更简短且效度更高的基于问卷的诊断，以便在大型流行病学研究中准确估计患病率。
