POTS is under diagnosed with an estimated prevalence of 0.2%. North American and Australian researchers, as well as patient groups have called for more research into POTS. However, there has been no comprehensive appraisal of the current POTS evidence base.

Aim

To map the POTS evidence base.

Methods

Two reviewers systematically searched 12 databases until July 1st 2019 using the search term “Postural Tachycardia Syndrome” (n = 7280) and categorised the literature. Inclusion criteria included all adult published literature with no language restrictions. 779 papers are analysed and mapped.

Results

Seven themes were identified: symptomology and quality of life 16.8% (n = 132), biomedical topics 16.5% (n = 130), co-morbidities 10.3% (n = 81), non-pharmacological management 9.8% (n = 77), aetiologies 6.9% (n = 53), pharmacological management 6.7% (n = 53), and clinical management 6.6% (n = 52). There 45 subthemes. Quality appraisal of the research studies (n = 233) evaluated design, sample size, outcome measures, data analysis and research biases. 74.8% (n = 175) were observational designs and 25.2% (n = 59) were experimental designs (16 using a randomised controlled design, 11 of which had a sample size greater than 21). 47.4% (n = 111) of studies only measured duration of effect for <1 day. 11.5% (n = 27) of studies reported outcomes using an unvalidated subjective measurement tool.

Conclusion

The volume of adult POTS literature is small and the validity and reliability of the research lacks rigour. The evidence map methodology provides POTS researchers with a benchmark for research thus far. This paper adds an in-depth research appraisal to the broad calls for action, highlighting the pressing need for multicentre, good quality research in POTS, to support guidelines and consensus development in the future.

中文翻译：

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了解体位性直立性心动过速综合征 (POTS) 的未来研究需求：映射 POTS 成人文献的证据

POTS 诊断不足，估计患病率为 0.2%。北美和澳大利亚的研究人员以及患者团体呼吁对 POTS 进行更多研究。然而，目前还没有对当前的 POTS 证据基础进行全面评估。

目的

绘制 POTS 证据库。

方法

两名审稿人使用搜索词“姿势性心动过速综合征”（n = 7280）系统地搜索了 12 个数据库，直到 2019 年 7 月 1 日，并对文献进行分类。纳入标准包括所有已发表的成人文献，没有语言限制。779篇论文被分析和映射。

结果

确定了七个主题：症状学和生活质量 16.8% (n = 132)、生物医学主题 16.5% (n = 130)、合并症 10.3% (n = 81)、非药物治疗 9.8% (n = 77) 、病因 6.9% (n = 53)、药物管理 6.7% (n = 53) 和临床管理 6.6% (n = 52)。有45个子主题。研究的质量评估 (n = 233) 评估了设计、样本量、结果测量、数据分析和研究偏差。74.8% (n = 175) 是观察性设计，25.2% (n = 59) 是实验设计（16 个使用随机对照设计，其中 11 个的样本量大于 21）。47.4% (n = 111) 的研究仅测量了 <1 天的效果持续时间。11.5% (n = 27) 的研究报告了使用未经验证的主观测量工具的结果。

结论

成人 POTS 文献量少，研究的效度和信度缺乏严谨性。证据图方法为 POTS 研究人员提供了迄今为止的研究基准。本文对广泛的行动呼吁进行了深入的研究评估，强调迫切需要在 POTS 中进行多中心、高质量的研究，以支持未来的指南和共识发展。