Changing outcome in inflammatory neuropathies Rasch-comparative responsiveness

Thomas H P Draak, Els K. Vanhoutte, Sonja I. Van Nes, Kenneth C. Gorson, W. Ludo Van Der Pol, Nicolette C. Notermans, Eduardo Nobile-Orazio, Jean Marc Léger, Peter Y K Van Den Bergh, Giuseppe Lauria, Vera Bril, Hans Katzberg, Michael P T Lunn, Jean Pouget, Anneke J. Van Der Kooi, Angelika F. Hahn, Pieter A. Van Doorn, David R. Cornblath, Leonard H. Van Den Berg, Catharina G. FaberIngemar S J Merkies

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Abstract

Objectives: We performed responsiveness comparison between the patient-reported Inflammatory Rasch-built Overall Disability Scale (I-RODS) and the widely used clinician-reported Inflammatory Neuropathy Cause and Treatment-Overall Neuropathy Limitation Scale (INCAT-ONLS) in patients with Guillain-Barré syndrome (GBS), chronic inflammatory demyelinating polyradiculoneuropathy (CIDP), and immunoglobulin M-monoclonal gammopathy of undetermined significance related polyneuropathy (IgM-MGUSP). Methods: One hundred thirty-seven patients (GBS: 55, CIDP: 59, IgM-MGUSP: 23) with a new diagnosis or clinical relapse assessed both scales. Patients with GBS/CIDP were examined at 0, 1, 3, 6, and 12 months; patients with IgM-MGUSP at 0, 3, and 12. We subjected all data to Rasch analyses, and calculated for each patient the magnitude of change on both scales using the minimal clinically important difference (MCID) related to the individual standard errors (SEs). A responder was defined as having anMCID-SE$1.96. Individual scores on both measures were correlated with the EuroQoL thermometer (heuristic responsiveness). Results: The I-RODS showed a significantly higher proportion of meaningful improvement compared with the INCAT-ONLS findings in GBS/CIDP. For IgM-MGUSP, the lack of responsiveness during the 1-year study did not allow a clear separation. Heuristic responsiveness was consistently higher with the I-RODS. Conclusion: The I-RODS more often captures clinically meaningful changes over time, with a greater magnitude of change, compared with the INCAT-ONLS disability scale in patients with GBS and CIDP. The I-RODS offers promise for being a more sensitive measure and its use is therefore suggested in future trials involving patients with GBS and CIDP.

Original languageEnglish
Pages (from-to)2124-2132
Number of pages9
JournalNeurology
Volume83
Issue number23
DOIs
Publication statusPublished - Dec 1 2014

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ASJC Scopus subject areas

  • Clinical Neurology
  • Medicine(all)

Cite this

Draak, T. H. P., Vanhoutte, E. K., Van Nes, S. I., Gorson, K. C., Van Der Pol, W. L., Notermans, N. C., Nobile-Orazio, E., Léger, J. M., Van Den Bergh, P. Y. K., Lauria, G., Bril, V., Katzberg, H., Lunn, M. P. T., Pouget, J., Van Der Kooi, A. J., Hahn, A. F., Van Doorn, P. A., Cornblath, D. R., Van Den Berg, L. H., ... Merkies, I. S. J. (2014). Changing outcome in inflammatory neuropathies Rasch-comparative responsiveness. Neurology, 83(23), 2124-2132. https://doi.org/10.1212/WNL.0000000000001044