Comparison of Scoring Systems for Assessment of Acute Mountain Sickness

Wagner, Dale R., Masaru Teramoto, Jonathan R. Knott, and Jack P. Fry Comparison of Scoring Systems for Assessment of Acute Mountain Sickness. High Alt Med Biol. 13:245-251, 2012.-The purpose of this study was to compare three commonly used scoring systems of acute mountain sickness (AMS)-the 5-item Lake Louise Self-report (LLS), the 11-item abridged version of the Environmental Symptoms Questionnaire (ESQ-III), and a 100mm visual analog scale (VAS)-on climbers (N = 63; 34.6 +/- 9.9 years) making a 1-day ascent of a 5640m peak after a rest of similar to 10 h at 4260 m. The prevalence of AMS was 63% when defined as LLS >= 3, 49% when defined as either LLS 5 or ESQ-III >= 0.7, and 41% when defined as the combined LLS and ESQ-III criteria. Despite the agreement in prevalence between the LLS >= 5 and ESQ-III >= 0.7, there was a discrepancy in AMS classification in 16% of the cases. A VAS cut-off point corresponding to the combined LLS and ESQ-III criteria was 16mm. The sensitivity and specificity of the VAS for diagnosing AMS compared to combined LLS and ESQ-III criteria were 85% and 92%, respectively. All of the scoring systems were significantly correlated (tau = 0.60 to 0.73, p < 0.01); however, residual scores were large. We cannot recommend interchanging the diagnostic results from the LLS, ESQ-III, and VAS, and standardization is needed for the administration of the VAS.