Impairment measures versus inflammatory RODS in GBS and CIDP: a responsiveness comparison

Media type: E-Article
Title: Impairment measures versus inflammatory RODS in GBS and CIDP: a responsiveness comparison
Contributor: 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.
Published: Wiley, 2015
Published in: Journal of the Peripheral Nervous System, 20 (2015) 3, Seite 289-295
Language: English
DOI: 10.1111/jns.12118
ISSN: 1085-9489; 1529-8027
Origination:
Footnote:
Description: <jats:title>Abstract</jats:title><jats:p>This study aimed to ‘define responder’ through the concept of minimum clinically important differences using the individually obtained standard errors (<jats:styled-content style="fixed-case">MCID‐SE</jats:styled-content>) and a heuristic ‘external criterion’ responsiveness method in patients with Guillain‐Barré syndrome (<jats:styled-content style="fixed-case">GBS</jats:styled-content>) and chronic inflammatory demyelinating polyradiculoneuropathy (<jats:styled-content style="fixed-case">CIDP</jats:styled-content>). One hundred and fourteen newly diagnosed or relapsing patients (<jats:styled-content style="fixed-case">GBS</jats:styled-content>: 55, <jats:styled-content style="fixed-case">CIDP</jats:styled-content>: 59) were serially examined (1‐year follow‐up). The inflammatory Rasch‐built overall disability scale (I‐<jats:styled-content style="fixed-case">RODS</jats:styled-content>), Rasch‐transformed <jats:styled-content style="fixed-case">MRC</jats:styled-content> sum score (<jats:styled-content style="fixed-case">RT‐MRC</jats:styled-content>), and Rasch‐transformed modified‐<jats:styled-content style="fixed-case">INCAT</jats:styled-content>‐sensory scale (<jats:styled-content style="fixed-case">RT‐mISS</jats:styled-content>) were assessed. Being‐a‐responder was defined as having a <jats:styled-content style="fixed-case">MCID‐SE</jats:styled-content> cut‐off ≥1.96. Also, the correlations between patients' scores on each scale and the <jats:styled-content style="fixed-case">EuroQoL</jats:styled-content> health‐status ‘thermometer’ (external criterion) were determined (higher correlation indicated better responsiveness). In both diseases, the <jats:styled-content style="fixed-case">SEs</jats:styled-content> showed a characteristic ‘U’‐shaped dynamic pattern across each scales' continuum. The number of patients showing a meaningful change were higher for the I‐<jats:styled-content style="fixed-case">RODS</jats:styled-content> > <jats:styled-content style="fixed-case">RT‐MRC</jats:styled-content> > <jats:styled-content style="fixed-case">RT‐mISS</jats:styled-content> and were in <jats:styled-content style="fixed-case">GBS</jats:styled-content> higher than <jats:styled-content style="fixed-case">CIDP</jats:styled-content> patients. The <jats:styled-content style="fixed-case">MCID‐SE</jats:styled-content> 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‐<jats:styled-content style="fixed-case">RODS</jats:styled-content> showed greater responsiveness compared with the <jats:styled-content style="fixed-case">MRC</jats:styled-content> and <jats:styled-content style="fixed-case">INCAT</jats:styled-content>‐sensory scales, and its use is therefore recommended in future trials in <jats:styled-content style="fixed-case">GBS</jats:styled-content> and <jats:styled-content style="fixed-case">CIDP</jats:styled-content>.</jats:p>

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