Advertisement
Mayo Clinic Proceedings Home

COMPASS 31: A Refined and Abbreviated Composite Autonomic Symptom Score

      Abstract

      Objective

      To develop a concise and statistically robust instrument to assess autonomic symptoms that provides clinically relevant scores of autonomic symptom severity based on the well-established 169-item Autonomic Symptom Profile (ASP) and its validated 84-question scoring instrument, the Composite Autonomic Symptom Score (COMPASS).

      Patients and Methods

      We assessed the internal consistency of COMPASS using Cronbach α coefficients based on the ASP of 405 healthy control subjects recruited and seen in the Mayo Clinic Autonomic Disorders Center between March 1, 1995, and March 31, 2010. Applying a simplified scoring algorithm, we then used exploratory factor analysis with orthogonal rotation and eigenvalue calculations to extract internally consistent domains and to reduce dimensionality. This analysis was followed by expert revisions to eliminate redundant content and to retain clinically important questions and final assessment of the new instrument.

      Results

      The new simplified scoring algorithm alone resulted in higher Cronbach α values in all domains. Factor analysis revealed 7 domains with a total of 54 questions retained. Expert revisions resulted in further reduction of questions and domains with a remaining total of 31 questions in 6 domains (COMPASS 31). Measures of internal consistency were much improved compared to those for COMPASS. Following appropriate weighting, this instrument provides an autonomic symptom score from 0 to 100.

      Conclusion

      COMPASS 31 is a refined, internally consistent, and markedly abbreviated quantitative measure of autonomic symptoms. It is based on the original ASP and COMPASS, applies a much simplified scoring algorithm, and is suitable for widespread use in autonomic research and practice.

      Abbreviations and Acronyms:

      ASP (Autonomic Symptom Profile), COMPASS (Composite Autonomic Symptom Score)
      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to Mayo Clinic Proceedings
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Suarez G.A.
        • Opfer-Gehrking T.L.
        • Offord K.P.
        • Atkinson E.J.
        • O'Brien P.C.
        • Low P.A.
        The Autonomic Symptom Profile: a new instrument to assess autonomic symptoms.
        Neurology. 1999; 52: 523-528
        • Benrud-Larson L.M.
        • Dewar M.S.
        • Sandroni P.
        • Rummans T.A.
        • Haythornthwaite J.A.
        • Low P.A.
        Quality of life in patients with postural tachycardia syndrome.
        Mayo Clin Proc. 2002; 77: 531-537
        • Benrud-Larson L.M.
        • Sandroni P.
        • Haythornthwaite J.A.
        • Rummans T.A.
        • Low P.A.
        Correlates of functional disability in patients with postural tachycardia syndrome: preliminary cross-sectional findings.
        Health Psychol. 2003; 22: 643-648
        • Benrud-Larson L.M.
        • Sandroni P.
        • Schrag A.
        • Low P.A.
        Depressive symptoms and life satisfaction in patients with multiple system atrophy.
        Mov Disord. 2005; 20: 951-957
        • Low P.A.
        • Benrud-Larson L.M.
        • Sletten D.M.
        • et al.
        • European MSA-Study Group
        Autonomic symptoms and diabetic neuropathy: a population-based study.
        Diabetes Care. 2004; 27: 2942-2947
        • Schrag A.
        • Geser F.
        • Stampfer-Kountchev M.
        • et al.
        Health-related quality of life in multiple system atrophy.
        Mov Disord. 2006; 21: 809-815
        • Thaisetthawatkul P.
        • Boeve B.F.
        • Benarroch E.E.
        • et al.
        Autonomic dysfunction in dementia with Lewy bodies.
        Neurology. 2004; 62: 1804-1809
        • Wieling W.
        • Shen W.K.
        Syncope: approach to management.
        in: Low P.A. Benarroch E.E. Clinical Autonomic Disorders. 3rd ed. Lippincott Williams & Wilkins, Philadelphia2008: 493-514
        • Feldman H.A.
        • Goldstein I.
        • Hatzichristou D.G.
        • Krane R.J.
        • McKinlay J.B.
        Impotence and its medical and psychosocial correlates: results of the Massachusetts Male Aging Study.
        J Urol. 1994; 151: 54-61
        • Finger W.W.
        • Lund M.
        • Slagle M.A.
        Medications that may contribute to sexual disorders: a guide to assessment and treatment in family practice.
        J Fam Pract. 1997; 44: 33-43
        • DeVellis R.F.
        Scale Development: Theory and Applications.
        Sage Publications, Newbury Park, CA1991
        • Landis J.R.
        • Koch G.G.
        The measurement of observer agreement for categorical data.
        Biometrics. 1977; 33: 159-174
        • Gorsuch R.L.
        Factor Analysis.
        2nd ed. Lawrence Erlbaum Associates, Hillsdale, NJ1983
        • Kaufmann H.
        • Malamut R.
        • Norcliffe-Kaufmann L.
        • Rosa K.
        • Freeman R.
        The Orthostatic Hypotension Questionnaire (OHQ): validation of a novel symptom assessment scale.
        Clin Auton Res. 2012; 22: 79-90
        • Schrezenmaier C.
        • Gehrking J.A.
        • Hines S.M.
        • Low P.A.
        • Benrud-Larson L.M.
        • Sandroni P.
        Evaluation of orthostatic hypotension: relationship of a new self-report instrument to laboratory-based measures.
        Mayo Clin Proc. 2005; 80: 330-334