[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"detail-sidebar-cat-0-en-105":3,"doc-seo-449544-105":59,"doc-detail-449544-en":130},{"code":4,"msg":5,"data":6},0,"success",[7,13,18,23,28,33,38,43,48,51,55],{"id":8,"doc_module":4,"doc_module_name":9,"category_name":10,"show_sort_weight":11,"slug":12},1,"Document","Story & Novel",90,"story-novel",{"id":14,"doc_module":4,"doc_module_name":9,"category_name":15,"show_sort_weight":16,"slug":17},2,"Literature",80,"literature",{"id":19,"doc_module":4,"doc_module_name":9,"category_name":20,"show_sort_weight":21,"slug":22},4,"Exam",70,"exam",{"id":24,"doc_module":4,"doc_module_name":9,"category_name":25,"show_sort_weight":26,"slug":27},5,"Comic",60,"comic",{"id":29,"doc_module":4,"doc_module_name":9,"category_name":30,"show_sort_weight":31,"slug":32},6,"Technology",50,"technology",{"id":34,"doc_module":4,"doc_module_name":9,"category_name":35,"show_sort_weight":36,"slug":37},7,"Healthcare",40,"healthcare",{"id":39,"doc_module":4,"doc_module_name":9,"category_name":40,"show_sort_weight":41,"slug":42},8,"Research & Report",30,"research-report",{"id":44,"doc_module":4,"doc_module_name":9,"category_name":45,"show_sort_weight":46,"slug":47},9,"Religion & Spirituality",20,"religion-spirituality",{"id":46,"doc_module":4,"doc_module_name":9,"category_name":49,"show_sort_weight":46,"slug":50},"World Cup","world-cup",{"id":52,"doc_module":4,"doc_module_name":9,"category_name":53,"show_sort_weight":52,"slug":54},10,"Lifestyle","lifestyle",{"id":56,"doc_module":4,"doc_module_name":9,"category_name":57,"show_sort_weight":24,"slug":58},19,"General","general",{"code":4,"msg":60,"data":61},"ok",{"site_id":62,"language":63,"slug":64,"title":65,"keywords":66,"description":67,"schema_data":68,"social_meta":123,"head_meta":125,"extra_data":127,"updated_unix":129},105,"en","autonomic-testing-model-coverage-policy-policy","Autonomic Testing Model Coverage Policy - policy","","Autonomic Testing Model Coverage Policy outlines the background, scope, and clinical role of autonomic testing for suspected autonomic disorders. It describes autonomic testing as an umbrella term covering sympathetic, parasympathetic, and enteric functions, focusing on standard sudomotor (sympathetic cholinergic), cardiovagal (parasympathetic), and sympathetic adrenergic tests. It explains that randomized controlled trials establishing efficacy have not been performed, while accumulated evidence over decades supports diagnostic and longitudinal value. It defines common testing terms and highlights limitations of automated device-based testing when key measurement requirements are not met.",{"@graph":69,"@context":122},[70,84,105],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/autonomic-testing-model-coverage-policy-policy/449544/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/autonomic-testing-model-coverage-policy-policy/449544.png","ImageObject",300,407,{"name":92,"@type":93},"noah","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-11-09","2026-09-30",true,{"@type":102,"interactionType":103,"userInteractionCount":39},"InteractionCounter",{"@type":104},"ViewAction",{"@type":106,"mainEntity":107},"FAQPage",[108,114,118],{"name":109,"@type":110,"acceptedAnswer":111},"What is the scope of autonomic testing in this policy?","Question",{"text":112,"@type":113},"The policy describes autonomic testing as covering sympathetic, parasympathetic, and enteric functions, with emphasis on standard sudomotor (sympathetic cholinergic), cardiovagal (parasympathetic), and sympathetic adrenergic tests.","Answer",{"name":115,"@type":110,"acceptedAnswer":116},"Why are randomized controlled trials for autonomic testing efficacy not established in this document?",{"text":117,"@type":113},"The document states that, like other accepted neurophysiologic tests and monitoring technologies, randomized controlled trials establishing efficacy have not been done, but current data from research and clinical experience support its role.",{"name":119,"@type":110,"acceptedAnswer":120},"What concerns are raised about automated autonomic testing devices?",{"text":121,"@type":113},"Automated devices that generate software interpretations have not been validated, and many use simplified test batteries that may be limited in validity due to missing measurement controls and beat-to-beat blood pressure requirements.","https://schema.org",{"og:url":83,"og:type":124,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":126,"canonical":83},"index,follow",{"doc_id":128,"site_id":62},449544,1791309021,{"code":4,"msg":5,"data":131},{"doc_id":128,"user_id":132,"nickname":92,"user_avatar":133,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":134,"file_id":135,"file_url":136,"file_type":137,"file_size":138,"view_count":39,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":52,"language":139,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":140,"faqs":141,"seo_title":142,"seo_description":67,"update_tm":143,"read_time":144,"preview_page_count":4},1099529839121,"https://ap-avatar.wpscdn.com/davatar_994ba38a5ba835b3df7d355c54d3ed8d","Model Coverage Policy  \nAutonomic Testing  \nChristopher H. Gibbons, MD, FAAN William P. Cheshire Jr., MD, FAAN Terry D. Fife, MD, FAAN  \nBACKGROUND  \n\n| The conceptual framework for autonomic testing began atthe turn of the 19th century with a number of experiments in basic neurophysiology. These original tests were developed over time into a rigorously defined, standardized series of autonomic tests that are useful in the clinical assessment and care of patients with suspected autonomic disorders. Autonomic testing has been widely used in clinical practice for 50 years, with decades of extensive experience and thousands of studies published on its use. Comprehensive textbooks have been published on the purpose and methodology of autonomic testing.1–4\u003Cbr>Autonomic testing is an umbrella term that covers testing of the various branches of the nervous system: the sympathetic, parasympathetic, and enteric. It should be noted that the autonomic nervous system extends to nearly every organ system in the body; so many organ specific tests are in fact tests of autonomic function (such as urodynamic studies, gastric motility testing, pupillometry, tests of lacrimal and salivary gland production, etc.) . For the purposes of this\u003Cbr>COMMON AUTONOMIC TESTING TERMS | policy, we will focus on the standard tests of sudomotor (sympathetic cholinergic), cardiovagal (parasympathetic) and sympathetic adrenergic system function.\u003Cbr>As is true for other accepted tests of neurophysiologic function and clinical monitoring technologies, randomized controlled trials establishing the efficacy of autonomic testing have not been done. However, current data, accumulated through scientific research and clinical experience and published in peer-reviewed journals over the past 50 years, have defined the role of autonomic testing in the diagnosis and management of autonomic disorders in clinical practice and established the value of autonomic testing in the longitudinal study of disease.\u003Cbr>Autonomic testing is an integral component of the clinical evaluation of patients with autonomic disorders. Autonomic Disorders is an established subspecialty recognized by the United Council on Neurologic Subspecialties (UCNS), which certifies physicians and laboratories with training and expertise in this discipline. |\n| --- | --- |\n\nAutonomic Nervous System: The part of the nervous system that controls involuntary visceral actions.  \nCardiovagal: The parasympathetic response measured via cardiac function, which is under control of the vagus nerve, which influences heart rate variability.  \nHeart Rate Variability: A test of parasympathetic function in which an individual undergoes a standard series of breathing exercises and the variability in the heart rate response is measured. Diminished heart rate variability (diminished respiratory sinus arrhythmia) is a sign of parasympathetic dysfunction.  \nQuantitative Sudomotor Axon Reflex Test: A test to evaluate the integrity of postganglionic sudomotor nerves along the axon reflex to define the volume and distribution of sweat loss. This is accomplished by releasing acetylcholine into the skin, which activates distal postganglionic sudomotor nerves, when then activates receptors on the eccrine sweat  \ngland. The sweat response is typically recorded from four sites (one forearm and three lower extremity sites) and the waveforms generated are assessed for deficits.  \nSudomotor: The sympathetic cholinergic component of the autonomic nervous system is responsible for sweat gland function and the production of thermoregulatory sweating.  \nSympathetic Skin Response: A test to measure a provoked change in the electrical potential of the skin.  \nThermoregulatory Sweat Test (TST): A test of sweat function and its neurologic regulation in which a generalized thermoregulatory sweating response is elicited by raising the core body temperature and monitoring sweat production by an indicator dye applied to the skin of the whole body (typi","cbCainaWnP7VLoBf","https://ap.wps.com/l/cbCainaWnP7VLoBf","pdf",166443,"English","# Model Coverage Policy\n## Background\n## Common Autonomic Testing Terms\n## Variations in Methods of Testing and Automated Devices","[{\"question\":\"What is the scope of autonomic testing in this policy?\",\"answer\":\"The policy describes autonomic testing as covering sympathetic, parasympathetic, and enteric functions, with emphasis on standard sudomotor (sympathetic cholinergic), cardiovagal (parasympathetic), and sympathetic adrenergic tests.\"},{\"question\":\"Why are randomized controlled trials for autonomic testing efficacy not established in this document?\",\"answer\":\"The document states that, like other accepted neurophysiologic tests and monitoring technologies, randomized controlled trials establishing efficacy have not been done, but current data from research and clinical experience support its role.\"},{\"question\":\"What concerns are raised about automated autonomic testing devices?\",\"answer\":\"Automated devices that generate software interpretations have not been validated, and many use simplified test batteries that may be limited in validity due to missing measurement controls and beat-to-beat blood pressure requirements.\"}]","Autonomic Testing Model Coverage Policy - policy | PDF",1790730538,25]