Validation of a questionnaire for orthostatic hypotension for routine clinical use

AIM: To validate a new patient-reported outcome measure for routine clinical use. METHODS: A total of 50 older individuals with orthostatic hypotension who attended a falls and syncope clinic completed three questionnaires, the recently developed Orthostatic Hypotension Questionnaire, the existing Orthostatic Grading Scale and the quality of life measure EQ-5D-5L. Validity of the Orthostatic Hypotension Questionnaire was tested against the aforementioned questionnaires for symptoms and for quality of life. Comorbidity was quantified using the Charlson Comorbidity Index. RESULTS: The cohort of 50 individuals had a median age of 67 years (interquartile range 26-89 years) with a median Charlson Comorbidity Index of 3 (interquartile range 2-5). The total Orthostatic Hypotension Questionnaire Symptom Assessment score correlated strongly with the Orthostatic Grading Scale (0.616, P < 0.001) and the Orthostatic Hypotension Questionnaire Daily Activity Scale correlated strongly with daily activity on the EQ-5D-5L (0.61, P < 0.001). Using the Orthostatic Grading Scale, individuals' symptoms were categorized as mild, moderate or severe, the Orthostatic Hypotension Questionnaire scores were significantly different between these groups (P < 0.001). Internal consistency was high (Cronbach's apha 0.882), and ceiling or floor effects did not limit the total scores. CONCLUSION: The Orthostatic Hypotension Questionnaire is a valid patient report tool to quantify the symptom burden of people with orthostatic hypotension. Because the symptoms associated with orthostatic hypotension are frequently non-specific, it will be a clinically useful tool to measure and quantify symptom load in people with orthostatic hypotension. Geriatr Gerontol Int 2016; 16: 785-790.