多変量解析を用いた小児起立性調節障害のサブタイプ分類支援に関する考察

抄録

Orthostatic dysregulation (OD) is an autonomic nervous disorder of the circulatory system that occurs in students in the higher grades of elementary school and in high school. It has been reported to affect approximately 700,000 Japanese children and 30%-40% of children out of school. OD is often neglected because the primary symptoms reported by parents of children with OD include difficulty in waking up in the morning, headache, dizziness, and tiredness, which are also considered as personality traits. OD diagnosis is performed by a specialist in accordance with the guidelines established by the Japanese Society of Pediatric Psychosomatic Medicine in 2006. The test classifies OD into four subtypes, and each subtype is differently treated. However, because there are few OD specialists, a doctor's experience is often used for subtype classification. We attempted to determine the reproducibility of the doctor's rule of thumb using multivariate analysis, which is the simplest available method using the blood pressure and heart rate data obtained from the test. We obtained a discriminant accuracy of approximately 92% for the two most common OD subtypes. Despite the primary subtypes and limited subject data, we obtained positive results, potentially reproducing the doctor's rule of thumb.