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Thanks but I actually meant the 1993 Schondorf-Low paper where POTS was first defined: Idiopathic postural orthostatic tachycardia syndrome An attenuated form of acute pandysautonomia? Ronald Schondorf, PhD, MD, and Phillip A. Low, MDAUTHORS INFO & AFFILIATIONS January 1993 issue 43 (1_part_1)...

Thanks for the useful references @Nightsong Found some other ones too: Orthostatic heart rate does not predict symptomatic burden in pediatric patients with chronic orthostatic intolerance - PubMed (nih.gov) Orthostatic intolerance without postural tachycardia: how much dysautonomia? -...

Thanks. Does anyone have access to this paper? Haven't been able to find it online.

Where does the idea that >30bpm increase during tilt testing is pathologic came from? Does anyone know how this threshold was justified or where it was first used?

There were 252 participants in this study of which 123 in the age group of 18-29 (where POTS diagnosis is common). They only did 5 instead of 10 minute testing but don't think that would impact the conclusion (one would expect the HR increase to be even higher with 10 minute testing). Half of...

There are more of these. Plan to write a blog post about it to summarize the main findings. Might have important implications for POTS and OI research in ME/CFS.

Think I've more or less found what I was looking for: Normal versus abnormal: What normative data tells us about the utility of heart rate in postural tachycardia - PubMed (nih.gov) The authors did 5 minute tilt table testing in a sample of the general population and found that POT was quite...

Looks like a highly problematic article, suggesting the opposite of what actually should be done to help patients. It refers to the Cochrane review (Larun et al.) to argue that GET is beneficial and to the PACE trial to argue that pacing is not (they suggest the term should be abandoned)...

This is a historic paper from 1993 where POTS was first defined. I am very interested in reading what it says but do not have access to it. Anyone who can share a copy with me in PM?

Abstract To characterize the idiopathic postural orthostatic tachycardia syndrome (POTS), we reviewed the records of all patients aged 20 to 51 who presented to the Mayo Autonomic Reflex Laboratory and who exhibited tachycardia at rest or during head-up tilt. These patients were usually women...

Yes that is another big problem. But I meant something differently: a study that does tilt table testing in a representative sample of the general population to see how well POT correlates with OI and other symptoms.

The supplementary file gives the following data (my bolding): Head-up tilt table testing at 70 degrees from horizontal for up to 40 minutes was performed during which finger blood pressure (BP) was monitored continuously and upper arm blood pressure measured with a cuff every four minutes...

This paper looks to be important for the origin of the concept POTS: Schondorf and Low labeled the condition “idiopathic postural orthostatic tachycardia syndrome” in a series of adults, suggesting the cause was “a mild form of an acute autonomic neuropathy” Schondorf R, Low PA (1993)...

Thanks for sharing. It would be interesting to have data on tilt table testing in a large representative sample of the general population to see how well POT correlates with POTS symptoms. Does anyone know of such as study?

There author makes three interesting points about POTS in adolescents. The threshold for standing test should be lower than for a tilt table test because in the former you're still actively using your leg muscles to stand, promoting venous pumping. An increase of 40pm in adolescents is not...

It's also a strange thing to study: whether making up an explanation for symptoms makes the patient feel less ill. I assume that the main message from this paper is to tell doctors that it's ok to use some made-up explanation for symptoms they can't explain. It's not only allowed, it's now the...

Apparently, the symptoms are no longer medically unexplained. That seems to be the main message that they want to spread. In the introduction the authors write: "People with persistent physical symptoms commonly have poor experiences of health care8,9 and are often told that their symptoms...

This is the primary outcome, the PHQ-15

Another flaw: just noted that the statistical analysis section says: "...no adjustments were made for multiplicity."

Looks like a highly problematic study. It has the design A +B versus A. The control group got no intervention at all, only the usual care that the intervention group also received (in addition to the intervention itself). Patients and GPs were not blinded and they only used a subjective...