August 19, 2026Journal of Public Health and Primary CareOpen Access

Effectiveness of the Composite Autonomic Symptom Score 31 Scale in Evaluating Autonomic Dysfunction in Diabetic Peripheral Neuropathy: A Comparative Study Using Autonomic Function Testing as Reference

Q: What is the clinical evidence from this study?

Study design: Cross-Sectional. Population: Type 2 diabetes mellitus / Diabetic peripheral neuropathy (n=72). Intervention: Composite Autonomic Symptom Score 31 (COMPASS-31) vs. Autonomic function testing (AFT). Primary outcome: Diagnostic accuracy for autonomic dysfunction (Sensitivity 34.61%, specificity 60%, PPV 69.23%, NPV 26.08%).

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Why the study?

Autonomic dysfunction in diabetic peripheral neuropathy is common yet underdiagnosed, and the validity of the self-administered COMPASS-31 questionnaire compared to standardized autonomic function testing has not been fully established in diabetic populations.

Does the COMPASS-31 questionnaire accurately detect autonomic dysfunction in patients with type 2 diabetes mellitus compared to standardized autonomic function testing?

Population

72 patients with type 2 diabetes mellitus of more than 1-year duration

Comparison

COMPASS-31 questionnaire vs standardized autonomic function testing as reference standard

Design

Observational cross-sectional study

Key result

The COMPASS-31 scale demonstrated moderate diagnostic accuracy for autonomic dysfunction in type 2 diabetes, with a sensitivity of 34.61% and specificity of 60% compared to autonomic function testing.

Authors

DSDube Suchitra SHSandipM Hulke SWSantosh Wakode

Discussion

Member takes

Overview

COMPASS-31 lacks sufficient accuracy for clinical screening of autonomic dysfunction in diabetes; leaves open need for validated alternatives in prospective studies.

Key Points

To assess the diagnostic accuracy and validity of the COMPASS-31 questionnaire compared to standardized autonomic function testing in patients with diabetic peripheral neuropathy.
Conducted an observational cross-sectional study at AIIMS Bhopal involving 72 patients with type 2 diabetes mellitus of more than 1 year duration.
Assessed participants using the COMPASS-31 questionnaire, heart rate variability (HRV) indices, and cardiovascular reflex tests based on Ewing's criteria as the reference standard.
Autonomic dysfunction was detected in 72% of participants by autonomic function testing and in 36% by the COMPASS-31 scale.
COMPASS-31 demonstrated a sensitivity of 34.61%, specificity of 60%, positive predictive value of 69.23%, and negative predictive value of 26.08%.
Significant positive correlations occurred between COMPASS-31 scores and multiple HRV indices (r > 0.5, P < 0.001).

Study Design

Type

Cross-Sectional (n=72)

Multicenter

Structured PICO

Does the COMPASS-31 questionnaire accurately detect autonomic dysfunction in patients with type 2 diabetes mellitus compared to standardized autonomic function testing?

Population

72 patients with type 2 diabetes mellitus of more than 1-year duration evaluated for autonomic dysfunction using the COMPASS-31 questionnaire and autonomic function testing.

Exposure

Composite Autonomic Symptom Score 31 (COMPASS-31) questionnaire

Comparator

Standardized autonomic function testing (AFT) including heart rate variability (HRV) parameters and cardiovascular reflex tests according to Ewing’s criteria

Outcome

Diagnostic accuracy measures (sensitivity, specificity, positive predictive value, and negative predictive value) of COMPASS-31 using AFT as the reference standardsurrogate

Main Result

Effect estimate: Sensitivity 34.61%, specificity 60%, PPV 69.23%, NPV 26.08%

Absolute Event Rate: 36% vs 72%

The COMPASS-31 scale provides a feasible, noninvasive method for preliminary screening of autonomic dysfunction in diabetic peripheral neuropathy, though it has only moderate diagnostic accuracy.

Cite This Study

Suchitra et al. (2026) conducted a cross-sectional in Type 2 diabetes mellitus / Diabetic peripheral neuropathy (n=72). Composite Autonomic Symptom Score 31 (COMPASS-31) vs. Autonomic function testing (AFT) was evaluated on Diagnostic accuracy for autonomic dysfunction (Sensitivity 34.61%, specificity 60%, PPV 69.23%, NPV 26.08%). The COMPASS-31 scale demonstrated moderate diagnostic accuracy for autonomic dysfunction in type 2 diabetes, with a sensitivity of 34.61% and specificity of 60% compared to autonomic function testing.

synapsesocial.com/papers/6a85637603308d306e2d69f9 https://doi.org/10.4103/jphpc.jphpc_1_26

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August 19, 2026Journal of Public Health and Primary CareOpen Access

Effectiveness of the Composite Autonomic Symptom Score 31 Scale in Evaluating Autonomic Dysfunction in Diabetic Peripheral Neuropathy: A Comparative Study Using Autonomic Function Testing as Reference

View Full Paper

Ask AI

Bookmark

Why the study?

Does the COMPASS-31 questionnaire accurately detect autonomic dysfunction in patients with type 2 diabetes mellitus compared to standardized autonomic function testing?

Population

72 patients with type 2 diabetes mellitus of more than 1-year duration

Comparison

COMPASS-31 questionnaire vs standardized autonomic function testing as reference standard

Design

Observational cross-sectional study

Key result

Authors

DSDube Suchitra SHSandipM Hulke SWSantosh Wakode

Discussion

Member takes

Overview

COMPASS-31 lacks sufficient accuracy for clinical screening of autonomic dysfunction in diabetes; leaves open need for validated alternatives in prospective studies.

Key Points

To assess the diagnostic accuracy and validity of the COMPASS-31 questionnaire compared to standardized autonomic function testing in patients with diabetic peripheral neuropathy.
Conducted an observational cross-sectional study at AIIMS Bhopal involving 72 patients with type 2 diabetes mellitus of more than 1 year duration.
Assessed participants using the COMPASS-31 questionnaire, heart rate variability (HRV) indices, and cardiovascular reflex tests based on Ewing's criteria as the reference standard.
Autonomic dysfunction was detected in 72% of participants by autonomic function testing and in 36% by the COMPASS-31 scale.
COMPASS-31 demonstrated a sensitivity of 34.61%, specificity of 60%, positive predictive value of 69.23%, and negative predictive value of 26.08%.
Significant positive correlations occurred between COMPASS-31 scores and multiple HRV indices (r > 0.5, P < 0.001).

Study Design

Type

Cross-Sectional (n=72)

Multicenter

Structured PICO

Does the COMPASS-31 questionnaire accurately detect autonomic dysfunction in patients with type 2 diabetes mellitus compared to standardized autonomic function testing?

Population

72 patients with type 2 diabetes mellitus of more than 1-year duration evaluated for autonomic dysfunction using the COMPASS-31 questionnaire and autonomic function testing.

Exposure

Composite Autonomic Symptom Score 31 (COMPASS-31) questionnaire

Comparator

Standardized autonomic function testing (AFT) including heart rate variability (HRV) parameters and cardiovascular reflex tests according to Ewing’s criteria

Outcome

Diagnostic accuracy measures (sensitivity, specificity, positive predictive value, and negative predictive value) of COMPASS-31 using AFT as the reference standardsurrogate

Main Result

Effect estimate: Sensitivity 34.61%, specificity 60%, PPV 69.23%, NPV 26.08%

Absolute Event Rate: 36% vs 72%

The COMPASS-31 scale provides a feasible, noninvasive method for preliminary screening of autonomic dysfunction in diabetic peripheral neuropathy, though it has only moderate diagnostic accuracy.

Cite This Study

synapsesocial.com/papers/6a85637603308d306e2d69f9 https://doi.org/10.4103/jphpc.jphpc_1_26

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