TABLE 4.
Differences in equipment, personnel, metrics, case mix of the patients referred to the clinical autonomic nervous system laboratories between macro‐European regions
| South/East/Greater Europe (16 laboratories) | North/West Europe (30 laboratories) | p value | |
|---|---|---|---|
| Equipment | |||
| Blood pressure monitoring, n (%) | |||
| Riva‐Rocci | 5 (31.3) | 14 (46.7) | 0.362 |
| Invasive continuous | 0 (0) | 4 (13.3) | 0.282 |
| Noninvasive continuous | 13 (81.3) | 28 (93.3) | 0.325 |
| Volume clamp | 7 (43.8) | 20 (66.7) | 0.209 |
| Pulse wave | 8 (50) | 11 (36.7) | 0.531 |
| Other (photopletysmography) | 1 (6.3) | 0 (0) | 0.348 |
| Heart rate monitoring, n (%) | |||
| ECG | 16 (100) | 30 (100) | ‐ |
| Other | 4 (25) | 4 (13.3) | 0.421 |
| Sweat testing, n (%) | 15 (93.8) | 23 (76.7) | 0.230 |
| Sympathetic skin response | 12 (75) | 17 (56.7) | 0.338 |
| Quantitative sudomotor axon reflex test | 4 (25) | 10 (33.3) | 0.739 |
| Electrochemical skin conductance | 3 (18.8) | 7 (23.3) | 1.000 |
| Thermoregulatory sweat test | 2 (12.5) | 4 (13.3) | 1.000 |
| Other | 2 (12.5) | 1 (3.3) | 0.542 |
| Blood testing, n (%) | |||
| Catecholamines | 9 (56.3) | 20 (66.7) | 0.534 |
| Antibodies | 8 (50) | 18 (60) | 0.548 |
| Other | 0 (0) | 4 (13.3) | 0.282 |
| Histology, n (%) | |||
| Dermal fiber density | 8 (50) | 21 (70) | 0.213 |
| Other | 1 (6.3) | 4 (13.3) | 0.645 |
| CASS a | 3 (18.8) | 10 (33.3) | 0.333 |
| Personnel*, n (%) | |||
| Head of the laboratory | |||
| Female | 9 (56.3) | 9 (30) | 0.116 |
| Age group | |||
| 30–39 years | 2 (12.5) | 6 (20) | 0.742 |
| 40–49 years | 7 (43.8) | 14 (46.7) | |
| 50–59 years | 5 (31.3) | 9 (30) | |
| 60–69 years | 2 (12.5) | 1 (3.3) | |
| Years into practice, n (%) | |||
| Resident | 0 | 2 (6.7) | 0.530 |
| Junior consultant (0–4 years) | 0 | 1 (3.3) | |
| Consultant (5–9 years) | 2 (12.5) | 2 (6.7) | |
| Senior consultant (10–19 years) | 4 (25) | 12 (40) | |
| >20 years | 10 (62.5) | 13 (43.3) | |
| Number of consultants, median (IQR) | 2 (1–2.75) | 2 (1–4) | 0.649 |
| Number of residents, mean ± SD | 0.75 ± 0.775 | 1.97 ± 2.189 | 0.009 |
| Number of PhD students, median (IQR) | 1 (0–1.75) | 0.5 (0–2) | 0.911 |
| Number of postdoctoral fellows, median (IQR) | 0 (0–0) | 0 (0–0) | 0.937 |
| Number of medical students, median (IQR) | 1 (0–1.75) | 1 (0–2) | 0.807 |
| Number of technicians, median (IQR) | 1 (1–2) | 1 (0–2.25) | 0.772 |
| Number of nurses, median (IQR) | 1 (0–1) | 1 (0–2.25) | 0.530 |
| Number of biomedical engineers, median (IQR)s | 0 (0–1) | 0 (0–1) | 0.802 |
| Laboratory metrics**, median (IQR) | |||
| Number of tilt table tests per year | 130 (41–250) | 100 (50–265.5) | 0.917 |
| Number of outpatient visits per year | 175 (105–380) | 212 (100–350) | 1.000 |
| Number of inpatient visits per year | 75 (32.5–129.75) | 10 (2.75–25) | 0.036 |
| Case mix in the respective laboratories*** | |||
| Reflex syncope, %, mean ± SD | 22.0 ± 19.0 | 19.8 ± 18.6 | 0.702 |
| Neurogenic orthostatic hypotension, %, mean ± SD | 21 ± 15 | 20 ± 19.9 | 0.857 |
| Postural orthostatic tachycardia syndrome, %, mean ± SD | 6.6 ± 9.9 | 13.8 ± 16.9 | 0.125 |
| Initial orthostatic hypotension, %, mean ± SD | 7.6 ± 9.6 | 4.8 ± 4.7 | 0.188 |
| Non‐neurogenic orthostatic hypotension, %, mean ± SD | 7.2 ± 7.7 | 6.5 ± 6.8 | 0.757 |
| Delayed orthostatic hypotension, %, mean ± SD | 4 ± 4.7 | 3.6 ± 3.6 | 0.727 |
| Psychogenic pseudosyncope, %, mean ± SD | 3.3 ± 3.0 | 4.9 ± 4.2 | 0.186 |
| Cardiac syncope, %, median (IQR) | 1 (0–10) | 0 (0–3.5) | 0.571 |
| Other transient loss of consciousness, %, median (IQR) | 2 (0–8.75) | 0 (0–5) | 0.152 |
Note: Due to corrections for multiple comparisons, every section has corrected p value for statistical significance, calculated according to number of comparisons.
Abbreviations: CASS, Composite Autonomic Severity Score; ECG, electrocardiogram; IQR, interquartile range; SD, standard deviation.
a
Quantitative sudomotor axon reflex test and (invasive or noninvasive continuous blood pressure) and heart rate monitoring devices.
*p < 0.006; **p < 0.017; ***p < 0.006.