Recurrent syncope as a chronic disease: preliminary validation of a disease-specific measure of functional impairment.
BACKGROUND
A disease-specific measure of functional health in syncope would provide an important outcome measure for use either in clinical trials or in the clinical management of patients with recurrent syncope.


METHODS
In a previous study the authors used formal functional status measures to determine physical and psychosocial impairment in recurrent syncope. This study provides a preliminary assessment of a disease-specific measure of function. The measure was pilot tested on 84 subjects, and validated in a separate cohort of 49 patients. The measure consists of 1) an 11-question matrix of yes/no questions, assessing the ways that syncope interferes with a patient's life (the result is expressed as a proportion of the total number of ways that syncope might interfere and is called the Impairment Score), and 2) three Likert-scale questions that assess the patient's fear and worry about syncope. Correlations were obtained between scores on the disease-specific measure and other measures of functional health.


RESULTS
Among the 49 patients in the test cohort, final scores on the disease-specific measure correlated with both physical and psychosocial dimension scores on a measure of functional status, the Sickness Impact Profile (r = 0.35-0.36, p = 0.01), and with five of ten subscale scores on a measure of psychological distress, the Symptom Checklist 90-R (r = 0.30-0.43, p = 0.004-0.02).


CONCLUSIONS
This new disease-specific quality-of-life measure in syncope measures both physical and psychosocial components of impairment and could be a valuable adjunct in measuring outcomes in syncope patients.
Division of General Internal Medicine, Duke University Medical Center, Durham, North Carolina.
M
M
Linzer
D T
DT
Gold
M
M
Pontinen
G W
GW
Divine
A
A
Felder
W B
WB
Brooks
D000203:Activities of Daily Living; D001294:Attitude to Health; D015331:Cohort Studies; D005260:Female; D006304:Health Status; D006801:Humans; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D010865:Pilot Projects; D011788:Quality of Life; D012008:Recurrence; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D013575:Syncope / Q000453:epidemiology* / Q000523:psychology