NYMC Faculty Publications

Assessment of Comorbid Symptoms in Pediatric Autonomic Dysfunction

Sally E. Tarbell, Northwestern University Feinberg School of Medicine, Chicago, IL, USA. Sally.Tarbell@northwestern.edu.
Erin L. Olufs, Iowa Stead Family Children's Hospital, Iowa City, IA, USA.
Philip R. Fischer, Mayo Clinic, Rochester, MN, USA.
Gisela Chelimsky, Children's Hospital of Richmond, Richmond, VA, USA.
Mohammed T. Numan, University of Texas McGovern Medical School, Houston, TX, USA.
Marvin Medow, New York Medical College, Valhalla, NY, USA.
Hasan Abdallah, Children's Heart Institute, Herndon, VA, USA.
Shelley Ahrens, Mayo Clinic, Rochester, MN, USA.
Jeffrey R. Boris, Jeffrey R. Boris, MD LLC, Moylan, PA, USA.
Ian J. Butler, University of Texas McGovern Medical School, Houston, TX, USA.
Thomas C. Chelimsky, Virginia Commonwealth University Health, Richmond, VA, USA.
Craig Coleby, Granger Medical Clinic, Riverton, UT, USA.
John E. Fortunato, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
Raewyn Gavin, Starship Children's Hospital, Auckland, New Zealand.
Janice Gilden, Rosalind Franklin University of Medicine and Science, North Chicago, IL, USA.
Renato Gonik, University of Florida College of Medicine, Gainesville, FL, USA.
Kelsey Klaas, Mayo Clinic, Rochester, MN, USA.
Lauren Marsillio, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
Erin Marriott, American Family Children's Hospital, Madison, WI, USA.
Laura A. Pace, Metrodora Institute, Salt Lake City, UT, USA.
Paul Pianosi, University of Minnesota Medical School, Minneapolis, MN, USA.
Pippa Simpson, Medical College of Wisconsin, Milwaukee, WI, USA.
Julian Stewart, New York Medical College, Valhalla, NY, USA.
Natalie Van Waning, Iowa Stead Family Children's Hospital, Iowa City, IA, USA.
Debra E. Weese-Mayer, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.

Author Type(s)

Faculty

Journal Title

Clinical Autonomic Research

First Page

843

Last Page

858

Document Type

Article

Publication Date

12-1-2023

Department

Pediatrics

Abstract

PURPOSE: Pediatric patients with autonomic dysfunction and orthostatic intolerance (OI) often present with co-existing symptoms and signs that might or might not directly relate to the autonomic nervous system. Our objective was to identify validated screening instruments to characterize these comorbidities and their impact on youth functioning. METHODS: The Pediatric Assembly of the American Autonomic Society reviewed the current state of practice for identifying symptom comorbidities in youth with OI. The assembly includes physicians, physician-scientists, scientists, advanced practice providers, psychologists, and a statistician with expertise in pediatric disorders of OI. A total of 26 representatives from the various specialties engaged in iterative meetings to: (1) identify and then develop consensus on the symptoms to be assessed, (2) establish committees to review the literature for screening measures by member expertise, and (3) delineate the specific criteria for systematically evaluating the measures and for making measure recommendations by symptom domains. RESULTS: We review the measures evaluated and recommend one measure per system/concern so that assessment results from unrelated clinical centers are comparable. We have created a repository to apprise investigators of validated, vetted assessment tools to enhance comparisons across cohorts of youth with autonomic dysfunction and OI. CONCLUSION: This effort can facilitate collaboration among clinical settings to advance the science and clinical treatment of these youth. This effort is essential to improving management of these vulnerable patients as well as to comparing research findings from different centers.

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