Journal of Sports Medicine

Research Article

Diagnosis of Overtraining Syndrome: Results of the Endocrine and Metabolic Responses on Overtraining Syndrome Study: EROS-DIAGNOSIS

Table 2

Clinical parameters evaluated for the development of the Endocrine and Metabolic Responses on Overtraining Syndrome diagnostic tools.


Study/tests	Markers	p-score	Highest NPV or PPV (%) and accuracy (%)	Ranges of the maximum accuracy and maximum true positive and true negative values	Useful for any of the questionnaires (no/potentially/yes)

EROS-PROFILE

Eating patterns	Calorie intake (kcal/kg/day)	<0.001	Cutoff: 32–40 kcal/kg/day; PPV: 100%; NPV: 96.1%; accuracy: 97.4%	OTS: 13/14 if <32 kcal/kg/day; ATL: 25/25 if >40 kcal/kg/day or 22/25 if >47 kcal/kg/day; accuracy: 38/39 if 32–40 kcal/kg/day	Yes
	Protein intake (g/kg/day)	<0.001	Cutoff: 1.7 g/kg/day; PPV: 92.9%; NPV: 85.7%; accuracy: 84.6%	OTS: 14/14 if <2.5 g/kg/day, 13/14 if <2.2 g/kg/day or 10/14 if <1.6 g/kg/day; ATL: 24/25 if >1.6 g/kg/day or 19/25 if >2.5 g/kg/day; accuracy: 33/39 if 1.7 g/kg/day	Yes
	Carbohydrate intake (g/kg/day)	0.003	Cutoff: 5–5.4 g/kcal/day; PPV: 70%; NPV: 100%; accuracy: 84.6%	OTS: 14/14 if <5 g/kg/day or 10/14 if <3.2 g/kg/day; ATL: 23/25 if <3 g/kg/day or 18/25 if >6.5 g/kg/day; accuracy: 33/39 if 5–5.4 g/kg/day	Yes
	Fat intake (g/kg/day)	n/s	n/a	n/a	No

Social patterns	Self-reported sleep quality (0–10)	0.004	Cutoff: ≤5; PPV: 85.7%; NPV: 70.4%; accuracy: 82.1%	OTS: 12/14 if >8; ATL: 18/25 if <7; accuracy: 32/39 if ≤5	Potentially
	Duration of night sleep (h)	n/s	n/a	n/a	No
	Number of hours of activities (h/day)	<0.001	Cutoff: ≥9 h; PPV: 83.3%; NPV: 72.7%; accuracy: 74.4%	OTS: 10/14 if >7 h/day or 14/14 if >5 h/day; ATL: 25/25 if ≤10 h/day or 24/25 if ≤8 h/day; accuracy: 29/39 if ≥9 h/day	Potentially
	Self-reported libido (0–10)	0.024	Cutoff: ≤5; PPV: 66.7%; NPV: 73.3%; accuracy: 71.8%	OTS: 9/14 if <7 or 11/14 if <8; ATL: 22/25 if >5 or 20/25 if >6; accuracy: 28/39 if ≤5	Potentially

Psychological patterns	Total POMS questionnaire score (−32 to 120)	<0.001	Cutoff: 24–30; PPV: 100%; NPV: 89.3%; accuracy: 92.3%	OTS: 14/14 if >6, 13/14 if >18, or 11/14 if >24–30; ATL: 25/25 if <24 or 20/25 if <2; accuracy: 36/39 if 24–30	Yes
	POMS anger subscale (0–48)	0.003	Cutoff: ≥11; PPV: 81.8%; NPV: 82.2%; accuracy: 82.1%	OTS: 13/14 if >19 or 9/14 if >11; ATL: 23/25 if <11 or 19/25 if <8; accuracy: 32/39 if ≥11	Yes
	POMS confusion subscale (0–28)	0.001	Cutoff: ≥6; PPV: 85.7%; NPV: 75%; accuracy: 76.9%	OTS: 10/14 if >4 or 6/14 if >6; ATL: 24/25 if <6; accuracy: 30/39 if >6	Yes
	POMS depression subscale (0–60)	0.008	Cutoff: ≥9; PPV: 85.7%; NPV: 73.3%; accuracy: 76.9%	OTS: 6/14 if >9 or 8/14 if >6; ATL: 22/25 if <9 or 21/25 if <6; accuracy: 30/39 if <9	Yes
	POMS fatigue subscale (0–28)	<0.001	Cutoff: 5–7; PPV: 100%; NPV: 100%; accuracy: 100%	OTS: 14/14 if >8 or 12/14 if >13; ATL: 25/25 if <5; accuracy: 39/39 if 5–8	Yes
	POMS tension subscale (0–36)	<0.001	Cutoff: ≥13; PPV: 84.6%; NPV: 88.5%; accuracy: 87.2%	OTS: 14/14 if >5 or 11/14 if >13; ATL: 23/25 if <13; accuracy: 34/39 if 12 or 13	Yes
	POMS vigour subscale (0–32)	<0.001	Cutoff: ≤18; PPV: 100%; NPV: 96.2%; accuracy: 97.4%	OTS: 13/14 if <18; ATL: 25/25 if >18, 25/25 if >20, or 23/25 if >23; accuracy: 38/39 if >18–20	Yes

Body metabolism	Measured:predicted BMR (%)	0.013	Cutoff: <102%; PPV: 62.5%; NPV: 82.6%; accuracy: 74.4%	OTS: 13/14 if <108% or 10/14 if <102%; ATL: 19/25 if >102%; accuracy: 29/39 if 102%	Potentially
	Percentage of fat burned compared with total BMR (%)	<0.001	Cutoff: <38%; PPV: 75%; NPV: 74.2%; accuracy: 74.4%; good for PPV and NPV; not good for accuracy	OTS: 14/14 if <58% or 6/14 if <40% and <30%; ATL: 23/25 if >20% or >38%; accuracy: 29/39 if <30–38%	Potentially

Body composition	Body fat (%)	<0.001	Cutoff: >17%; PPV: 80%; NPV: 70.6%; accuracy: 76.9%	OTS: 14/14 if >10%, 7/14 if >15% or 4/14 if >17%; ATL: 24/25 if <17% or 22/25 if <15%; accuracy: 30/39 if >17%	Yes
	Muscle mass (%)	0.008	Cutoff: <47%; PPV: 100%; NPV: 75.8%; accuracy: 79.5%	OTS: 12/14 if <50% or 6/14 if <47%; ATL: 25/25 if >47%; accuracy: 31/39 if 47%	Yes
	Body water (%)	<0.001	Cutoff: <60%; PPV: 100%; NPV: 75.8%; accuracy: 79.5%	OTS: 14/14 if <65%, 13/14 if <63.5% or 6/14 if <60%; ATL: 25/25 if >60%; accuracy: 31/39 if 60%	Yes
	Extracellular water (%)	n/s	n/a	n/a	No
	Visceral fat (cm²)	0.01	Cutoff: >68 cm²: PPV: 87.5%; NPV: 77.4%; accuracy: 79.5%	OTS: 13/14 if >38 cm² or 7/14 if >68 cm²; ATL: 24/25 if <68 cm², 22/25 if <56 cm², or 14/25 if <38 cm²	Potentially
	Chest-to-waist circumference ratio	n/s	n/a	n/a	No

ATL = healthy athletes; BMR = basal metabolic rate; EROS = Endocrine and Metabolic Responses on Overtraining Syndrome; n/a = nonapplicable; NPV = negative predictive value; n/s = nonsignificant; OTS = overtraining syndrome-affected athletes; POMS = Profile of Mood States; PPV = positive predictive value. Not included for the analysis.