Validation of the Composite Autonomic Symptom Score 31 (COMPASS 31) for the assessment of symptoms of autonomic neuropathy in people with diabetes
Validation of the Composite Autonomic Symptom Score 31 (COMPASS 31) for the assessment of symptoms of autonomic neuropathy in people with diabetes
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DOI：
10.1111/dme.13310
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发表时间：
2017-06-01
影响因子：
3.5
通讯作者：
Spallone, V.
中科院分区：
文献类型：
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作者：
Greco, C.;Di Gennaro, F.;Spallone, V.
目的在一项以临床为基础的单中心研究中，验证意大利版的复合自主神经症状评分（COMPASS）31用于诊断糖尿病心血管自主神经病变。（年龄55 - 14岁）在根据心血管反射试验进行心血管自主神经病变和糖尿病多发性神经病变评估之前完成COMPASS 31问卷，结果COMPASS 31总加权评分在有和没有心血管自主神经病变的参与者之间存在差异（29.9士19.5比16.1士14.7; P = 0.003）和有和无糖尿病多发性神经病（28.9士19.1比12.7士11.3; P < 0.0001）。与心血管反射试验评分（rho = 0.38，P = 0.0013）、糖尿病多发性神经病症状（rho=0.61，P < 0.0001）和体征评分（rho = 0.49，P < 0.0001）相关。受试者工作曲线分析显示，心血管自主神经病变（曲线下面积0.748 ± 0.068，95% CI 0.599-0.861）和糖尿病多发性神经病变（曲线下面积0.742 +/- 0.061，95% CI 0.611-0.845）的总评分诊断准确性良好。早期心血管自主神经病变的最佳评分阈值为16（敏感性75.0%，特异性64.9%，阳性预测值37.5%，阴性预测值90.2%），17例同时确诊为心血管自主神经病变和糖尿病多发性神经病变（敏感性分别为70.0%和65.5%;特异性分别为66.7%和79.5%;阳性预测值分别为25.0%和67.9%;阴性预测值分别为93.0%和77.8%）。COMPASS 31的Cronbach's系数为0.73，内部一致性较好。结论COMPASS 31是一种有效、简便、定量评价糖尿病神经病变自主神经症状的工具，对心血管自主神经病变和糖尿病多发性神经病变的诊断准确率较高。
AimTo validate the Composite Autonomic Symptom Score (COMPASS) 31, in its Italian version, for the diagnosis of diabetic cardiovascular autonomic neuropathy in a clinic-based, single-centre study.MethodsA total of 73 participants with diabetes (age 55 14 years) completed the COMPASS 31 questionnaire before undergoing cardiovascular autonomic neuropathy and diabetic polyneuropathy assessment according to cardiovascular reflex tests, neuropathic symptoms and signs, and vibration and thermal thresholds.ResultsThe COMPASS 31 total weighted score differed between participants with and without cardiovascular autonomic neuropathy (29.9 19.5 vs 16.1 14.7; P = 0.003) and with and without diabetic polyneuropathy (28.9 19.1 vs 12.7 11.3; P < 0.0001). It was related to cardiovascular reflex tests score (rho = 0.38, P = 0.0013) as well as diabetic polyneuropathy symptoms (rho=0.61, P < 0.0001) and signs scores (rho = 0.49, P < 0.0001). Receiver-operating curve analysis showed a fair diagnostic accuracy of total score for cardiovascular autonomic neuropathy (area under the curve 0.748 0.068, 95% CI 0.599-0.861) and diabetic polyneuropathy (area under the curve 0.742 +/- 0.061, 95% CI 0.611-0.845). The best score thresholds were 16 for early cardiovascular autonomic neuropathy (sensitivity 75.0%, specificity 64.9%, positive predictive value 37.5% and negative predictive value 90.2%), and 17 for both confirmed cardiovascular autonomic neuropathy and diabetic polyneuropathy (sensitivity 70.0% and 65.5%, respectively; specificity 66.7% and 79.5%, respectively; positive predictive value 25.0% and 67.9%, respectively; and negative predictive value 93.0% and 77.8%, respectively). COMPASS 31 had a good internal consistency according to Cronbach's coefficient of 0.73.ConclusionsCOMPASS 31 can represent a valid, easy-to-use, quantitative assessment tool for autonomic symptoms in diabetic neuropathy, with a fair diagnostic accuracy for both cardiovascular autonomic neuropathy and diabetic polyneuropathy.