학술논문
Impairment measures versus inflammatory RODS in GBS and CIDP: a responsiveness comparison
Document Type
Academic Journal
Author
Vanhoutte, Els K.; Draak, Thomas H. P.; Gorson, Kenneth C.; van Nes, Sonja I.; Hoeijmakers, Janneke G. J.; Van der Pol, W.-Ludo; Notermans, Nicolette. C.; Lewis, Richard A.; Nobile-Orazio, Eduardo; Léger, Jean-Marc; Van den Bergh, Peter Y. K.; Lauria, Giuseppe; Bril, Vera; Katzberg, Hans; Lunn, Michael P. T.; Pouget, Jean; van der Kooi, Anneke J.; Hahn, Angelika F.; van Doorn, Pieter A.; Cornblath, David R.; van den Berg, Leonard H.; Faber, Catharina G.; Merkies, Ingemar S. J.; Barreira, A. A.; Bennett, D.; Hadden, R. D.; Hughes, R. A.C.; Lunn, M. P.T.; Reilly, M. M.; van den Berg, L. H.; van Doorn, P. A.; Faber, C. G.; van der Kooi, A. J.; Merkies, I. S.J.; Notermans, N. C.; Raaphorts, J.; van Schaik, I. N.; de Visser, M.; Cats, E. A.; Van den Bergh, P. Y.K.; Bombelli, F.; Costa, R.; Franques, J.; Léger, J-M.; Pouget, J.; Bril, V.; Hahn, A. F.; Katzberg, H.; Campanella, A.; Devigili, G.; Gallia, F.; Lauria, G.; Nobile-Orazio, E.; Padua, L.; Cornblath, D. R.; Gorson, K. C.; Lewis, R. A.; Illa, I; Querol, L.; van Nes, S. I.
Source
Journal of the Peripheral Nervous System. Sep 01, 2015 20(3):289-295
Subject
Language
English
ISSN
1085-9489
Abstract
This study aimed to ‘define responder’ through the concept of minimum clinically important differences using the individually obtained standard errors (MCID-SE) and a heuristic ‘external criterion’ responsiveness method in patients with Guillain-Barré syndrome (GBS) and chronic inflammatory demyelinating polyradiculoneuropathy (CIDP). One hundred and fourteen newly diagnosed or relapsing patients (GBS: 55, CIDP: 59) were serially examined (1-year follow-up). The inflammatory Rasch-built overall disability scale (I-RODS), Rasch-transformed MRC sum score (RT-MRC), and Rasch-transformed modified-INCAT-sensory scale (RT-mISS) were assessed. Being-a-responder was defined as having a MCID-SE cut-off ≥1.96. Also, the correlations between patientsʼ scores on each scale and the EuroQoL health-status ‘thermometer’ (external criterion) were determined (higher correlation indicated better responsiveness). In both diseases, the SEs showed a characteristic ‘U′-shaped dynamic pattern across each scalesʼ continuum. The number of patients showing a meaningful change were higher for the I-RODS > RT-MRC > RT-mISS and were in GBS higher than CIDP patients. The MCID-SE concept using Rasch-transformed data demonstrated an individual pattern of ‘being-a-responder’ in patients with immune-mediated neuropathies, and the findings were validated by the external criterion responsiveness method. The I-RODS showed greater responsiveness compared with the MRC and INCAT-sensory scales, and its use is therefore recommended in future trials in GBS and CIDP.