Empirical validation of the Horowitz Multiple Systemic Infectious Disease Syndrome Questionnaire for suspected Lyme disease.
Level 4 - case-series / case-control
Diagnostic case-control and psychometric validation study
PubMed 28919803 · doi:10.2147/IJGM.S140224
What was done
Three studies evaluated the psychometric validity and discriminative ability of the Horowitz Multiple Systemic Infectious Disease Syndrome Questionnaire (HMQ) for suspected Lyme disease. Study 1 assessed construct validity, factor structure, and reliability in 537 patients treated for Lyme disease. Study 2 evaluated convergent and discriminant validity in an online sample of 999 participants (217 self-identified healthy, 782 self-identified active Lyme disease). Study 3 compared 236 patients with confirmed Lyme disease against 568 online healthy controls.
What was found
Factor analysis yielded six latent dimensions, with four corresponding to neuropathy, cognitive dysfunction, musculoskeletal pain, and fatigue. The scale showed acceptable internal consistency via Cronbach's alpha and demonstrated convergent and divergent validity. The HMQ differentiated individuals with Lyme disease from healthy controls, with three migratory pain items (persistent muscular pain, arthritic pain, and nerve pain/paresthesias) identifying confirmed Lyme cases. No numerical performance metrics (such as sensitivity, specificity, or exact reliability coefficients) were reported in the abstract.
Why it matters
The findings provide preliminary validation for the HMQ as an inexpensive screening instrument to help practitioners identify patients who may warrant formal diagnostic testing for Lyme disease.
Limits
The abstract omits numeric diagnostic accuracy metrics (e.g., sensitivity, specificity, AUC). Testing against healthy controls rather than patients with mimicking conditions (e.g., fibromyalgia, chronic fatigue) limits applicability in differential diagnosis. Study 2 relied on unverified, self-reported online diagnoses.
Cited by
- supports The Horowitz Multiple Systemic Infectious Disease Syndrome (MSIDS) questionnaire was validated in a study of 1,600 people.