title: Assessment of autonomic symptoms in diabetics: the Swedish version of the Autonomic Symptom Profile.
abstract: OBJECTIVE
  Autonomic dysfunction (AD) is a complication of diabetes and may be associated with troubling symptoms and increased mortality. Commonly, AD is detected by objective physiological tests and only recently, a validated self-completed English questionnaire assessing AD symptoms, the Autonomic Symptom Profile (ASP), was developed. The aims of this study were to translate the ASP into Swedish and evaluate its reliability and validity.
  
  
  METHODS
  Forward and back translations were performed. Thirty-one patients with type I diabetes, 200 population-based controls and two AD experts participated in the study. Test-retest reliability was evaluated by letting 25 patients to fill in the ASP twice. Content validity was evaluated by two Swedish AD experts and construct validity was evaluated by studying associations between the ASP total score and five objective autonomic nervous function test variables. Finally, discriminant validity was evaluated by studying differences in the ASP total and domain scores between patients and controls.
  
  
  RESULTS
  The translation was accepted without changes. Test-retest reliability and content validity of the Swedish ASP were considered good. The construct validity was considered acceptable with two significant associations between the ASP total score and the autonomic nervous function test variables. In addition, discriminant validity was considered acceptable with regard to the ASP total score as well as the sexual dysfunction, sleep disorder and vasomotor dysfunction domain scores significantly differing between patients and controls.
  
  
  CONCLUSIONS
  The Swedish version of the ASP was considered a reliable and valid instrument for the study of AD symptoms in patients with type I diabetes.
authors.affiliation: Department of Rheumatology, Malmö University Hospital, Sweden. thomas.mandl@med.lu.se
authors.forename: Thomas
authors.initials: T
authors.lastname: Mandl
authors.forename: Viktoria
authors.initials: V
authors.lastname: Granberg
authors.forename: Jan
authors.initials: J
authors.lastname: Apelqvist
authors.forename: Per
authors.initials: P
authors.lastname: Wollmer
authors.forename: Rolf
authors.initials: R
authors.lastname: Manthorpe
authors.forename: Lennart T H
authors.initials: LT
authors.lastname: Jacobsson
mesh_terms: D001342:Autonomic Nervous System Diseases / Q000150:complications* / Q000175:diagnosis*; D003922:Diabetes Mellitus, Type 1 / Q000150:complications*; D020920:Dyssomnias / Q000150:complications / Q000175:diagnosis; D005260:Female; D006801:Humans; D007024:Hypotension, Orthostatic / Q000150:complications / Q000175:diagnosis; D008297:Male; D008875:Middle Aged; D015203:Reproducibility of Results; D012129:Respiratory Function Tests; D012735:Sexual Dysfunction, Physiological / Q000150:complications / Q000175:diagnosis; D012867:Skin / Q000098:blood supply; D011795:Surveys and Questionnaires / Q000592:standards*; D013548:Sweden