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Visual analogue self-assessment of acute mountain sickness in adolescents : experience from two Himalayan expeditions
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Slingo, Mary E., Lowe, Fionna S. J., Pieri, Andrew R. P. and Imray, C. (Chris) (2012) Visual analogue self-assessment of acute mountain sickness in adolescents : experience from two Himalayan expeditions. High Altitude Medicine & Biology, Vol.13 (No.3). pp. 185-192. doi:10.1089/ham.2012.1008 ISSN 1527-0297.
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Official URL: http://dx.doi.org/10.1089/ham.2012.1008
Abstract
Slingo, Mary E., Fionna S. J. Lowe, Andrew R. P. Pieri, Chris H. E. Imray, The British Schools Exploring Society. Visual analogue self-assessment of acute mountain sickness in adolescents: Experience from two Himalayan Expeditions. High Alt Med Biol. 13:185–192, 2012.—Objective: Recent studies have investigated visual analogue scales (VAS) as an alternative to the Lake Louise AMS Self-Report Score (LLS) for the self-assessment of acute mountain sickness (AMS). We investigated their use in adolescents.
Methods: The study was conducted during the 2009 and 2010 British Schools Exploring Society 35-day expeditions to Ladakh. Comparable ascent profiles were followed, reaching a maximum altitude of 6000 m. LLS and VAS AMS scores were recorded each morning. VAS comprised 100 mm lines for each LLS symptom; VAS scores were summed to give a composite daily total (VAS(c), expressed as a percentage). In 2010, an additional line was used to score overall “altitude sickness' (VAS(o)).
Results: 42 individuals participated in 2009 (83% compliance; mean age 17.4 years); 28 in 2010 (82% compliance; 17.5 years). 759 data points were recorded in 2009; 529 in 2010. There was a significant correlation between LLS and VAS(c) on both expeditions (rho=0.80, p<0.001 in 2009; rho=0.65, p<0.001 in 2010). These significant correlations remained when cases of AMS were analyzed separately. However, in all cases, the relationship between LLS and VAS was distorted, with a tendency for VAS to underscore symptoms of AMS when LLS<5. A VAS(c) value of 5.5% had an 82% specificity and sensitivity for all cases of AMS; VAS(c) of 9.5% had a 90% specificity and sensitivity for moderate and severe AMS.
Conclusions: Whilst adolescents are capable of self-monitoring for AMS using VAS, the relationship with LLS is distorted. The LLS, despite its limitations, therefore remains the preferred method for the self-assessment of AMS in adolescents.
| Item Type: | Journal Article | ||||
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| Divisions: | Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Biomedical Sciences > Translational & Experimental Medicine > Metabolic and Vascular Health (- until July 2016) Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School |
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| Journal or Publication Title: | High Altitude Medicine & Biology | ||||
| Publisher: | Mary Ann Liebert, Inc. Publishers | ||||
| ISSN: | 1527-0297 | ||||
| Official Date: | September 2012 | ||||
| Dates: |
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| Volume: | Vol.13 | ||||
| Number: | No.3 | ||||
| Page Range: | pp. 185-192 | ||||
| DOI: | 10.1089/ham.2012.1008 | ||||
| Status: | Peer Reviewed | ||||
| Publication Status: | Published | ||||
| Access rights to Published version: | Restricted or Subscription Access |
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