title: Bayesian estimation of cardiovascular autonomic neuropathy diagnostic test based on short-term heart rate variability without a gold standard.
abstract: OBJECTIVE
  To evaluate the reference values for short-term heart rate variability (HRV), estimate the performance of cardiovascular autonomic neuropathy (CAN) diagnostic tests in the absence of a gold standard, and assess CAN prevalence in our dataset.
  
  
  METHODS
  Community and hospital health centre.
  
  
  METHODS
  Of 2092 subjects available for data analysis, 371 healthy subjects were selected so the reference values for the short-term HRV test could be evaluated. An external dataset contained 88 subjects who completed both the short-term HRV test and Ewing's test.
  
  
  METHODS
  Collection of information on clinical outcome.
  Cardiovascular autonomic function evaluated by using the short-term HRV test and/or Ewing's test.
  
  
  RESULTS
  Cut-off points of 356.13, 55.45 and 36.64 ms2 were set for total power, low frequency and high frequency (HF), respectively. The diagnostic test for CAN based on the mentioned reference value was created. The HRV test had a high sensitivity (80.01-85.09%) and specificity (82.30-85.20%) for CAN. In addition, the non-inferiority test rejected the null hypothesis that the performance of the HRV test was inferior to that of Ewing's test (p<0.05). The estimated CAN prevalence was 14.92% and 29.17% in the total sample and patients with diabetes, respectively.
  
  
  CONCLUSIONS
  Our findings provided reference values for short-term HRV, which were used for the CAN diagnostic test with high sensitivity and specificity. The estimated CAN prevalence was high in the Chinese population.
authors.affiliation: Department of Endocrinology and Metabolism, Shanghai Tongji Hospital, Tongji University School of Medicine, Shanghai, China.|Department of Endocrinology and Metabolism, Fudan University Huashan Hospital, Shanghai, China.
authors.forename: Zi-Hui
authors.initials: ZH
authors.lastname: Tang
authors.affiliation: Department of Endocrinology and Metabolism, Shanghai Tongji Hospital, Tongji University School of Medicine, Shanghai, China.
authors.forename: Lin
authors.initials: L
authors.lastname: Wang
authors.affiliation: Department of Endocrinology and Metabolism, Fudan University Huashan Hospital, Shanghai, China.
authors.forename: Fangfang
authors.initials: F
authors.lastname: Zeng
authors.affiliation: Department of Endocrinology and Metabolism, Fudan University Huashan Hospital, Shanghai, China.
authors.forename: Zhongtao
authors.initials: Z
authors.lastname: Li
authors.affiliation: Department of Endocrinology and Metabolism, Fudan University Huashan Hospital, Shanghai, China.
authors.forename: Xiaoling
authors.initials: X
authors.lastname: Yu
authors.affiliation: Department of Endocrinology and Metabolism, Shanghai Tongji Hospital, Tongji University School of Medicine, Shanghai, China.
authors.forename: Keqin
authors.initials: K
authors.lastname: Zhang
authors.affiliation: Department of Endocrinology and Metabolism, Fudan University Huashan Hospital, Shanghai, China.
authors.forename: Linuo
authors.initials: L
authors.lastname: Zhou
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001341:Autonomic Nervous System / Q000503:physiopathology; D001342:Autonomic Nervous System Diseases / Q000175:diagnosis* / Q000503:physiopathology; D001499:Bayes Theorem; D002318:Cardiovascular Diseases / Q000175:diagnosis* / Q000503:physiopathology; D016022:Case-Control Studies; D003430:Cross-Sectional Studies; D005260:Female; D006334:Heart Function Tests; D006339:Heart Rate / Q000502:physiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012016:Reference Values
keywords: EPIDEMIOLOGY