Validity and reliability of autonomic symptom test

Resumen

INTRODUCTION: the cardiovascular autonomic neuropathy increases the risk of silent myocardial ischemia and intraoperative cardiovascular liability. Additionally, from 27 to 56% of the patients with this diagnosis dies in the following 5-10 years. Cardiovascular autonomic neuropathy is detected by means of an electrocardiograph registration that monitors changes in heart rate induced by different stimulus. The autonomic symptom profle evaluates symptoms of autonomic function but it was not considered their reliability and validity with cardiovascular autonomic neuropathy diagnosis. It was carried out a study to determine the validity and reliability of the autonomic symptoms profle in the diagnosis of cardiovascular autonomic neuropathy.

 MATERIALS AND METHODS: from june to december of 2005, 103 participants responded the questionnaire spanish version twice. Then, 52 participants took the autonomic function test; the validity of the content of the questionnaire was evaluated by the cronbach's alpha and the reliability test-retest by intraclass correlation coeffcient. It was considered the prevalence, sensibility and specifcity of the score obtained with the presence of cardiovascular autonomic neuropathy. 

RESULTS: The validity of content was good (cronbach's alpha >0,7). The reliability of the total score questionnaire was poor intraclass correlation coeffcient (ICC 0,36 0,06-0,6) and the discriminative capacity of the questionnaire for the detection of cardiovascular autonomic neuropathy was bad for anyone of the selected court points Receiver operating curve (ROC area 0,5). 

CONCLUSIONS: the questionnaire evaluates the symptoms of autonomous function consistently; it has a low reliability and poor discriminative capacity to defne the presence of cardiovascular autonomic neuropathy. 

Key words: Autonomic function. Reliability. Validity. Cardiovascular autonomic function. Neuropathy. Diabetes mellitus.