Validation of the Composite Autonomic Symptom Score 31 (COMPASS 31) for the assessment of symptoms of autonomic neuropathy in people with diabetes

Abstract

COMPASS 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.

The diagnostic usefulness of the combined COMPASS 31 questionnaire and electrochemical skin conductance for diabetic cardiovascular autonomic neuropathy and diabetic polyneuropathy

“…In the present study, COMPASS 31 would appear to retain similar characteristics of diagnostic performance for CAN and DPN, with values of AUC up to 0.73, sensitivity up to 75% and specificity up to 65%, but with values for DPN being slightly lower than in the previous study. This may be due to differences between the populations of the present and previous study like a larger sample size (102 vs 73), a longer diabetes duration (18 vs 12 years), and a higher prevalence of DPN (52% vs 40%). However, an AUC of 0.73 for confirmed CAN supports overall fair diagnostic accuracy of COMPASS 31 (a value >0.7).…”

“…Recently, we validated COMPASS 31 for autonomic symptoms of diabetic autonomic neuropathy . In the validation study, in 73 participants with diabetes, we observed that COMPASS 31 scores were associated with CAN and DPN, related to their severity, and that COMPASS 31 TWS had a fair diagnostic accuracy for CAN and DPN with AUCs of 0.75 for CAN and 0.74 for DPN, and sensitivity and specificity of 75% and 65.5% for CAN and of 65.5% and 79.5% for DPN . Moreover, COMPASS 31 had good internal consistency with a Cronbach's coefficient of 0.73 …”

“…Participants were requested to complete COMPASS 31 in its Italian version before undergoing the other examinations. According to our previous studies of validation of COMPASS 31 for autonomic symptoms of diabetic neuropathy, COMPASS 31 was considered abnormal in the presence of a total weighted score (TWS) >16.44 . Operators were blinded to the COMPASS 31 results.…”

“…Considering the results obtained with COMPASS 31 and ESC feet in the previous studies in participants with DPN or CAN, a sample size of ~ 90 was planned.…”

“…Composite autonomic symptom score (COMPASS) 31 was developed from COMPASS, which in turn had been derived from the autonomic symptom profile, by cutting the number of items from 169 to 31 questions . The COMPASS 31 questionnaire has been translated into Italian and validated according to standard procedures by Pierangeli et al Using this Italian version, we validated COMPASS 31 for autonomic symptoms of diabetic neuropathy and found a fair diagnostic accuracy for both CAN and diabetic polyneuropathy (DPN) with areas under the ROC curve of 0.75 and 0.74, respectively, and values of sensitivity up to 75% for CAN and of specificity up to 79% for DPN . COMPASS 31 had the additional advantage of being easy to use, inexpensive and of clinical relevance for patients.…”