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

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Vanhoutte, Els K Draak, Thomas H P Gorson, Kenneth C van Nes, Sonja I Hoeijmakers, Janneke G J Van den Bergh, Peter [UCL]

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 patients' 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 scales' 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.

Document type Article de périodique (Journal article) – Article de recherche
Access type Accès restreint
Publication date 2015
Language Anglais
Journal information "Journal of the peripheral nervous system" - Vol. 20, no.3, p. 289-295 (2015)
Peer reviewed yes
Publisher Wiley-Blackwell Publishing, Inc. ((United States) Hoboken, NJ)
issn 1085-9489
e-issn 1529-8027
Publication status Publié
Affiliations UCL - SSS/IONS/NEUR - Clinical Neuroscience
UCL - (SLuc) Service de neurologie
MESH Subject Adult ; Middle Aged ; Outcome Assessment (Health Care) ; Polyradiculoneuropathy, Chronic Inflammatory Demyelinating ; Sensation ; Young Adult ; Aged ; Aged, 80 and over ; Disability Evaluation ; Female ; Guillain-Barre Syndrome ; Humans ; Immunologic Factors ; Male
Keywords Immune-mediated neuropathies ; Minimum clinically important difference ; Outcome measure ; Rasch
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Bibliographic reference Vanhoutte, Els K ; Draak, Thomas H P ; Gorson, Kenneth C ; van Nes, Sonja I ; Hoeijmakers, Janneke G J ; et. al. Impairment measures versus inflammatory RODS in GBS and CIDP: a responsiveness comparison. In: Journal of the peripheral nervous system, Vol. 20, no.3, p. 289-295 (2015)
Permanent URL http://hdl.handle.net/2078.1/176014