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Validation of symptom measures in patients under investigation for postural orthostatic tachycardia syndrome (POTS):... 2023 Iris Knoop, Moss-Morris

Discussion in ''Conditions related to ME/CFS' news and research' started by Andy, Nov 19, 2023.

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  1. Andy

    Andy Committee Member

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    Full title: Validation of symptom measures in patients under investigation for postural orthostatic tachycardia syndrome (POTS): The Orthostatic Grading Scale (OGS) and the Symptom Screen for Small-fiber Polyneuropathy (SSS)

    Highlights
    • More standardized symptom reporting is needed in Postural Orthostatic Tachycardia Syndrome (POTS)
    • The Orthostatic Grading Scale (OGS) has been used in POTS studies but not validated
    • The Symptom Screen for Small-Fiber Neuropathy (SSS) has not previously been specifically used in POTS
    • The current study assessed the psychometric properties of the OGS and SSS in populations with suspected POTS
    • Both the OGS and the SSS are valid and reliable measures of symptom burden in POTS
    Abstract

    Objectives
    Postural Orthostatic Tachycardia Syndrome (POTS) presents with a range of poorly delineated symptoms across several domains. There is an urgent need for standardized symptom reporting in POTS, but a lack of validated symptom burden instruments. Our aim was to evaluate the psychometric properties of two symptom burden measures: the Orthostatic Grading Scale (OGS) and the Symptom Screen for Small-Fiber Polyneuropathy (SSS), in patients under investigation for suspected POTS.

    Design
    Psychometric validation study.

    Methods
    Confirmatory factor analysis (CFA) tested the factor structure of the SSS and OGS completed by 149 patients under investigation for POTS. Scale reliability and validity were assessed. The uni-dimensionality of the SSS was assessed through principal component analysis (PCA).

    Results
    CFA of the OGS revealed that a 1-factor structure had adequate fit. CFA of the SSS revealed that a 5-factor structure had generally appropriate fit supporting the originally proposed 5 factors (1: Gastrointestinal, 2: Somatosensory, 3: Miscellaneous, 4: Microvascular, and 5: Urological). In addition, the SSS demonstrated sufficient uni-dimensionality in the PCA, warranting use of a single total score. Omega coefficients of both measures indicated satisfactory internal reliability (0.668–0.931). Correlations with related constructs (distress (K10 score), r = 0.317–0.404, p < 0.001) and heart rate indices (with the OGS, r = 0.211–0.294, p < 0.05) suggested sound convergent and divergent validity.

    Conclusions
    Initial evidence suggests that the OGS and SSS have good psychometric properties for use in populations with suspected and confirmed POTS.

    Paywall, https://www.autonomicneuroscience.com/article/S1566-0702(23)00059-0/fulltext#
     
    Andy, Nov 19, 2023
    #1
    Hutan and Peter Trewhitt like this.
  2. Trish

    Trish Moderator Staff Member

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    The authors are all from the Health Psychology department at Kings, except for one consultant cardiologist.
     
    Trish, Nov 19, 2023
    #2
    MeSci, Lou B Lou, Peter Trewhitt and 2 others like this.
  3. Hutan

    Hutan Moderator Staff Member

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    If I was a cynical person, I might think that this is an attempt to add a subjective measure to a condition that is defined objectively. So a BPS intervention which might have little impact on the objective outcomes but, by changing the way a person reports symptoms, might still be able to claim to have improved subjectively reported symptoms of relevance to the condition.

    But, perhaps a measure of perceived symptom burden is ok. I'm not sure I understand all that is written here - it certainly could have been written more clearly.

    ? Does this mean a single composite number, or a single factor. If the latter, what factor?

    I don't think those r values for agreement between (what, the SSS and OGS?) and heart rate look very impressive and its barely statistically significant.
     
    Hutan, Nov 19, 2023
    #3
    alktipping, Sean, Peter Trewhitt and 1 other person like this.
  4. Trish

    Trish Moderator Staff Member

    Messages:
    52,503
    Location:
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    I can see the point of cardiologists assessing people for POTS asking about symptoms, and doctors generally learning to recognise symptom patterns that may be caused by POTS, so symptom questionnaires may be useful.

    I'm not sure what this has to do with health psychology. The use of psychometrics seems to be referring to the statistical processes psychologists use to validate their psychological and behavioural questionnaires.

    But this is surely about symptom recording and treatment appropriately handled by doctors, not about psychology.
     
    Trish, Nov 19, 2023
    #4
    MeSci, alktipping, Sean and 4 others like this.

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