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Clinical Autonomic Research

, Volume 29, Issue 1, pp 105–112 | Cite as

Initial validation of symptom scores derived from the orthostatic discriminant and severity scale

  • Jacquie Baker
  • Justin R. Paturel
  • David M. Sletten
  • Phillip A. Low
  • Kurt KimpinskiEmail author
Research Article

Abstract

Objective

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).

Methods

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.

Results

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.

Interpretation

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.

Keywords

Orthostatic intolerance Autonomic dysfunction Autonomic reflex screen Questionnaires 

Notes

Author contributions

JB and KK each contributed to experimental design, data analysis and manuscript preparation.

Compliance with ethical standards

Conflict of interest

On behalf of all authors, there are no conflicts of interest.

Supplementary material

10286_2018_511_MOESM1_ESM.pdf (328 kb)
Supplementary material 1 (PDF 327 kb)

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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  • Jacquie Baker
    • 1
    • 3
  • Justin R. Paturel
    • 1
  • David M. Sletten
    • 4
  • Phillip A. Low
    • 4
  • Kurt Kimpinski
    • 1
    • 2
    • 3
    Email author
  1. 1.Department of Clinical Neurological Sciences, London Health Sciences CentreRm. C7-131, University HospitalLondonCanada
  2. 2.Schulich School of Medicine and DentistryWestern UniversityLondonCanada
  3. 3.School of KinesiologyWestern UniversityLondonCanada
  4. 4.Department of NeurologyMayo ClinicRochesterUSA

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