Validation of the self-completed Cambridge-Hopkins questionnaire (CH-RLSq) for ascertainment of Restless legs Syndrome (RLS) in a population survey

Department of Neurology, Johns Hopkins University, Baltimore, MD 21224, USA.
Sleep Medicine (Impact Factor: 3.15). 03/2009; 10(10):1097-100. DOI: 10.1016/j.sleep.2008.10.007
Source: PubMed


Epidemiological studies of restless legs syndrome (RLS) have been limited by lack of a well validated patient-completed diagnostic questionnaire that has a high enough specificity to provide a reasonable positive predictive value. Most of the currently used patient completed diagnostic questionnaires have neither been validated nor included items facilitating the differential diagnosis of RLS from conditions producing similar symptoms. The Cambridge-Hopkins diagnostic questionnaire for RLS (CH-RLSq) was developed with several iterations to include items covering the basic diagnostic features of RLS and to provide some basic differential diagnosis. This validation study sought to determine the sensitivity and specificity of the RLS diagnosis based on this questionnaire.
The CH-RLSq was completed by 2005 blood donors who were asked to consent to being contacted for a telephone diagnostic interview. A scoring criterion was established for ascertainment of RLS based on the clinical definition of the disorder and the exclusion of "mimic" conditions. A weighted sample (N=185) of all completed questionnaires was selected for expert clinical diagnosis of RLS using the validated Hopkins Telephone Diagnostic Interview (HDTI). The telephone interviewers were blinded to all questionnaire responses.
A telephone diagnosis was obtained on 183 of the sample's 185 questionnaires. The questionnaire's normalized sensitivity and specificity were 87.2% and 94.4%, respectively, for RLS compared to not RLS. The positive predictive values in this sample were 85.5%.
The Cambridge-Hopkins RLS questionnaire provides a reasonable level of sensitivity and specificity for ascertainment of RLS in population-based studies.

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Available from: Brendan Burchell, Oct 26, 2015
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    • "Unfortunately, while the specificity of the four IRLSSG diagnostic criteria is good at 84%, it can be difficult to exclude mimics (e.g., leg cramps) which may confound the diagnosis of RLS [6]. There is an alternative RLS questionnaire, developed at Cambridge and Johns Hopkins, which may be more useful with a sensitivity of 87.2% and specificity of 94.4% [7]. "
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    • "To our surprise, we were not able to confirm that genotyping identified a useful proportion of the risk for restless legs or PLMS, but we were only able to genotype two of the several SNPs for which the strongest associations had been reported, and MEIS1 rs12469063 was technically difficult to genotype in our assay.15,33 Part of the explanation for our failure to demonstrate association may be the limited positive predictive value of the four criterion questions which we used to identify restless legs.23,35 Another problem may be the interference of sleep apnea with recognizing RLS, since there was a nominally significant association of the RLS questions with MEIS1 rs12469063 among those participants with lower AHI scores. "
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