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Iodine-starch test validity in amputee patients with hyperhidrosis
Colby Hansen1, Bradeigh Godfrey1,2, Alfred Balch3
1Department of Physical Medicine and Rehabilitation, University of Utah, Salt Lake City, Utah, USA.
Purpose:
Validate the iodine-starch test in amputees by comparing a novel measure, the Amputee Iodine-Starch Result (AISR) with the Hyperhidrosis Disease Severity Scale (HDSS) and to measure test-retest reliability in patients with hyperhidrosis.
Materials And Methods:
Amputee patients underwent iodine-starch testing using a previously described method. AISR was derived by visually inspecting sweat reactions on the residual limb and prosthetic sheath, scoring intensity using the Sweating Intensity Visual Scale (SIVS), measuring surface area involvement, and normalizing to residual limb surface area. Ordinal logistic regression for HDSS vs AISR was performed. Intraclass correlations (ICC) measured test-retest reliability.
Results:
91 participants, including 25 control participants, underwent iodine-starch testing. The ordinal logistic regression for HDSS vs AISR on both skin (AISR-SK) (2 = 10.57, OR = 2.91 (95% CI 1.48-5.73), p = 0.0011) and sheath (AISR-SH) (2 = 8.62, OR = 2.10 (95% CI 1.26-3.51), p = 0.0033) was highly significant. ICC showed poor test-retest reliability for skin (AISR-SK, r = 0.388, ICC = 0.393, 95% CI 0.028-0.662) and sheath (AISR-SH, r = 0.194, ICC = 0.198, 95% CI -0.189, 0.526) measurements.
Conclusions:
The iodine-starch test is significantly associated with HDSS, but has poor test-retest reliability.
