ResearchProposal

LindsayLeTellier
IndependentResearchIG/T
20152016

Title:
AMultitudeofMethods:TreatingPediatricPosturalOrthostaticTachycardiaSyndrome

IntroductionandOverviewofResearch:
ThegeneralareabeingstudiedispediatricPosturalOrthostaticTachycardiaSyndrome
(POTS)anditstreatments.Thissyndromecanbeagreatburdentothechildrenwhosufferfrom
it,andnotonlyistherecurrentlynocureforPOTS,buttherearesomanydifferenttreatments
thatareusedtosuppressthesymptomsandnoneofthemareeffectiveforallpatients.Itisoften
extremelydifficulttodesignaneffectivetreatmentplanforapediatricPOTSpatientbecauseof
howdifferenteachcaseis.Afterconsultingwithmanyphysiciansaroundthecountrywhotreat
pediatricPOTSviaaquestionnaire,thedifferentbeingusedbysaidphysicianswillbecompared
andcontrasted.Ideally,asaresultoftheanalysisofthetreatment,theresearcherwillbeableto
determinewhichofthetreatmentsbeingusedseemtobemosteffectiveintreatingthis
syndrome.

BackgroundandRationale:
PosturalOrthostaticTachycardiaSyndrome(POTS)iscomposedoftwogeneral
components:(1)symptomsoforthostaticintoleranceand(2)excessiveposturaltachycardia
(Kizilbash,etal,2014,p.112).Inpediatriccases,POTSischaracterizedbya
persistentrisein
heartrateofmorethan3040beatsperminutewhenstanding,orastandingheartrateofgreater
than120beatsperminute(LeGras,2013).Thesyndromeisaccompaniedbyanumberof
symptoms,witheachpatientsufferingdifferently.SymptomsassociatedwithPOTScaninclude
butarenotlimitedtolightheadedness,inabilitytoconcentrate,highlevelsoffatigue,sleepiness,
stabbingchestpainsuponstanding,exerciseintolerance,andlowqualityoflife(Raj,2013).
POTSisoftenadebilitatingconditiontothosewhosufferfromit,anditcanbeespecially
disablingtothechildrenwhomustdealwiththissyndrome.Thesymptomsthataccompanythis
syndromecanbesoseverethatayoungpersoncanbeprecludedfromengaginginactivitieslike
attendingschoolorparticipatinginathletics.EachcaseofpediatricPOTSisverydifferent,with
symptoms,severity,andcausesvaryingfromcasetocase.Forthisreason,pediatricPOTSis
treatedinanumberofdifferentwayswithnotonetreatmentbeingeffectiveforallpatients.Itis
treatedbothpharmacologicallyandnonpharmacologically,yetitisunknownwhichofthese
methodsismosteffective.
DifferentdoctorsaroundtheUnitedStateschoosetotreatpediatricPOTSinanumberof
differentwaysbasedonwhattheyfeelwillbemosteffectivefortheirpatients.Itwouldbe
beneficialnotonlytothesephysiciansbutalsototheirpatientsandthefamiliesoftheirpatients

iftheyknewhowotherdoctorsfromaroundthecountryweretreatingpediatricPOTS,aswellas
howeffectiveeachofthedifferenttreatmentsbeingusedareforpediatricpatients.By
researchingandcomparingandcontrastingthemanydifferenttreatmentsthatareusedtotreat
pediatricPOTS,itisalsoquitepossiblethatanidealstandardoftreatmentforthislifealtering
conditioncouldbediscovered.

ResearchMethodology:
I.
ResearchQuestion:
WhichtreatmentsforPosturalOrthostaticTachycardiaSyndromeare
mostcommonlyusedinpediatricpatients,andwhichofthesetreatmentsismost
effective?
II.
ResearchHypothesis:
Acombinationofpharmacologicalandnonpharmacological
treatmentstailoredtoeachindividualPOTSpatientismosteffectiveinreducingthe
symptomsofpediatricPOTS.
III.
ResearchDesignModel:
Thisprojectwillbeconductedusingdescriptiveresearchin
ordertodescribethevarioustreatmentmethodsbeingusedtotreatpediatricPostural
OrthostaticTachycardiaSyndrome.Aquestionnairewillbedistributedtoavarietyof
physiciansaroundtheUnitedStatestoassesshoweachofthemtypicallychoosestotreat
POTSintheirpediatricpatients.Thequestionnaireisstructuredsothatitmayelicitboth
quantitativeandqualitativeresults:someofthequestionsaremultiplechoiceorinthe
formofaLikertscale,andtheanswerstothesequestionscanbeeasilycounted,while
otherquestionsonthequestionnaireareopenendedsothattheresearchermaygather
moredetailedresults.Imbeddedinthequestionnairearetwosetsof
independentdependentvariablepairs.Thefirstindependentvariableisthephysician
fillingoutthequestionnairewhilethedependentvariableisthephysiciansopinions
regardinghowpediatricPOTSismosteffectivelytreated.Thesecondindependent
variableisthetreatmentortreatmentslistedbythephysicianfillingoutthequestionnaire,
whilethedependentvariableistheeffectivenessofsaidtreatmentasdefinedbythe
physician.
IV.
DataCollection:
Thisresearchtopicisbeingpursuedusingaquestionnaireafterthis
methodwassuggestedtotheresearcherbyDr.JeffreyBoris,apediatriccardiologistat
TheChildrensHospitalofPhiladelphia.Usingaquestionnaireallowstheresearcherto
easilydrawdatafromalargenumberofhumanresourcesandwillalsoprovidethe
researcherwithanexcellentbalanceofqualitativeandquantitativedata,whichis
essentialtothisprojectinthatthecombinationwillallowtheresearcherstudythistopic
atthemostindepthlevelpossible.
Betweentwentyandtwentyfivephysicianswillfilloutthequestionnaire.When
thedatahasbeenentirelycollected,theresearcherwillanalyzetheresultswiththehelp
ofanotherphysician.

ProductObjectives:
Attheconclusionoftheyearofstudy,apamphletwillbedeveloped.Thepamphletwill
includeinformationaboutthemanydifferenttreatmentsbeingusedtotreatpediatricPOTSby
differentphysiciansaroundthenationandwillgiveinformationaboutthesimilaritiesand
differencesbetweeneachofthetreatments.
Thetargetaudienceforsuchapamphletwouldbetheparentsofchildrenwhoare
sufferingfromPOTS.Parentswouldbeabletoreadthepamphletinordertoexploreallofthe
treatmentoptionsavailabletotheirchild.Physicianscouldalsoreferencethepamphlettogaina
quickideaofthedifferenttreatmentsbeingusedtotreatpediatricPOTSbydifferentphysicians.
TheoverallgoalofthepamphletwouldbetohelppediatricPOTSpatientsandtheirfamiliesto
learnmoreaboutthemanydifferenttreatmentoptionsthatareavailabletothem.Thisway,they
areawareofallofthedifferenttreatmentoptionsthattheycouldpursuesothattheycan
potentiallyattainrelieffromthissyndromeassoonaspossible.

LogisticalConsiderations:
ThequestionnairewillbedistributedusingafreeonlineprogramknownasSurvey
Monkey,sofewmonetarycostwouldbeincurredusingthisdatacollectionmethod.Apamphlet
wouldalsobeaninexpensiveproducttodevelop,asallthatwouldbenecessarywouldbepaper
andaccesstoacolorprinter.Alocationinwhichtoplacethepamphletsmustbearranged,orthe
pamphletcouldbepublishedviasomesortofonlinevenue.
BetweentwentyandtwentyfivephysicianswhotreatpediatricPOTSmustbeavailable
tofilloutthequestionnaireinordertocollectalargeenoughsampleofdata.Permissionmay
alsobenecessaryinordertopublishthephysiciansanswerstothequestionnaire.Aphysician
willalsobeneededtohelptheresearchertoanalyzetheresultsofthedata.
Atimelinewillbeaddedthatoutlinesthedatacollection,productdevelopment,and
audiencedistribution.

References
Kizilbash,S.J.,Ahrens,S.P.,Bruce,B.K.,Chelimsky,G.,Driscoll,S.W.,HarbeckWeber,C.,
.
..Fischer,P.R.(2014).Adolescentfatigue,POTS,andrecovery:Aguideforclinicians
[.pdf].DepartmentofPediatricandAdolescentMedicine,MayoClinic.

LeGras,M.(2013).OverviewofPOTSsyndrome.RetrievedDecember13,2015,fromPediatric
CardiologyCenterofOregonwebsite:
http://www.pccoforegon.com/blog/overviewofpotssyndrom
e

Raj,S.R.(2013).Posturaltachycardiasyndrome(POTS).RetrievedDecember13,2015,from

AmericanHeartAssociationwebsite:
http://circ.ahajournals.org/content/127/23/2336.long