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

Els K. Vanhoutte, Thomas H P Draak, Kenneth C. Gorson, Sonja I. Van Nes, Janneke G J Hoeijmakers, W. Ludo Van Der Pol, Nicolette C. Notermans, Richard A. Lewis, 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. CornblathLeonard H. Van Den Berg, Catharina G. Faber, Ingemar S J Merkies

Research output: Contribution to journalArticlepeer-review

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 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.

Original languageEnglish
Pages (from-to)289-295
Number of pages7
JournalJournal of the Peripheral Nervous System
Volume20
Issue number3
DOIs
Publication statusPublished - Sep 1 2015

Keywords

  • immune-mediated neuropathies
  • minimum clinically important difference
  • outcome measure
  • Rasch

ASJC Scopus subject areas

  • Clinical Neurology
  • Neuroscience(all)

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