Muppidi Srikanth
Department of Neurology and Neurological Sciences, Stanford University School of Medicine, Stanford, CA.
J Clin Neuromuscul Dis. 2017 Mar;18(3):135-146. doi: 10.1097/CND.0000000000000156.
The development of validated assessment tools for evaluating disease status and response to interventions in patients with myasthenia gravis (MG) has been driven by clinical studies of emerging MG therapies. However, only a small proportion of MG-focused neurology practices have adopted these assessment tools for routine clinical use. This article reviews the suitability of 5 assessment instruments for incorporation into clinical practice, which should be driven by their ability to contribute to improved patient outcomes, and to be implemented within practice personnel and resource constraints. It is recommended that assessments based on both physician-evaluated and patient-reported outcomes be selected, to adequately evaluate both point-in-time symptom load and functional impact of MG symptoms over time. Provider resource allocation and reimbursement issues may be the most significant roadblocks to successful ongoing use of these tools; to that end, the addition of regular assessments to MG standards of care is recommended.
用于评估重症肌无力（MG）患者疾病状态及对干预措施反应的经过验证的评估工具的开发，是由新兴MG疗法的临床研究推动的。然而，只有一小部分专注于MG治疗的神经科诊所将这些评估工具用于常规临床实践。本文回顾了5种评估工具纳入临床实践的适用性，这应由其对改善患者预后的贡献能力以及在实践人员和资源限制范围内实施的能力来驱动。建议选择基于医生评估和患者报告结果的评估方法，以充分评估MG症状的即时症状负荷和随时间推移的功能影响。提供者资源分配和报销问题可能是成功持续使用这些工具的最重大障碍；为此，建议在MG护理标准中增加定期评估。
