Validation and Diagnostic Accuracy of Hindi Restless Legs Syndrome (RLS-H) Screening Tool.

Abstract

Background Restless legs syndrome (RLS), a prevalent and treatable entity, has high impact on quality of life, requiring a better screening tool for its early detection. Thus, present study aimed to derive a Hindi RLS (RLS-H) screening tool for its use in Indian population. Materials and Methods RLS-H screening tool, derived by translating first four criteria of 2012 revised International Restless Legs Syndrome Study Group (IRLSSG) diagnostic criteria in Hindi and was validated in 50 RLS and 50 non-RLS patients. This validated RLS-H tool was used to screen 1,066 patients attending neurology clinic for assessing its diagnostic accuracy. Internal consistency, discriminatory validity, and various diagnostic yields were calculated. IRLSSG was used as gold standard for final diagnosis of RLS. Results RLS-H screening tool had an internal consistency of 0.910. No correlation was found between RLS-H screening tool and Epworth sleepiness scale, Pittsburgh sleep quality index, or International Restless Legs Syndrome Study Group rating scale indicating satisfactory discriminant validity. Prevalence of RLS was 13.6%. The question (Q)1 had highest sensitivity (97.9%) and Q4 had highest specificity (92.66%). Thus, its combinations (Q1 + Q4) along with addition of Q2 or Q3 were compared for best combination of diagnostic accuracy. A minimum cutoff value of RLS-H screening tool was 2.5 for considering patients requiring detailed RLS evaluation. Conclusion RLS-H screening tool can be used as a screening tool for early detection of RLS among susceptible patients. Patients answering “yes” to more than two questions (cutoff = 2.5) or “yes” to Q1 and Q4 should be interviewed and assessed for RLS.