Department of Neurology, Leiden University Medical Center, Leiden, The Netherlands.
Department of Medicine, Division of Neurology, University Health Network and University of Toronto, Toronto, Canada.
J Neuromuscul Dis. 2020;7(3):297-300. doi: 10.3233/JND-200484.
The recently developed Myasthenia Gravis Impairment Index (MGII) is a promising measure as it has less floor effects and a higher relative efficiency in its responsiveness to treatment effect compared to other MG measures. This study aimed at validating the MGII in a Dutch cohort of MG patients and analyzing the sensitivity of MGII compared to MG-ADL for changes in generalized weakness.
We analyzed (generalized items of; -gen) MGII, quantitative myasthenia gravis (QMG), Myasthenia Gravis Activities of Daily Living (MG-ADL), EQ-5D visual analog, Myasthenia Gravis Composite (MGC) and ACTIVLIM (an ADL questionnaire focusing on generalized weakness) scores in a prospective cohort of 99 MG patients. We investigated correlations between MGII and other outcome measures. We used a generalized linear model to assess whether MGIIgen had an additional sensitivity on top of MG-ADLgen for changes (Δ) in QMGgen in individual patients.
MGII had a lower floor effect (4%) compared to QMG (6%), MG-ADL (11%) and MGC (16%). MGII correlated well with QMG (r = 0.68), MG-ADL (r = 0.83) and MGC (r = 0.74). As expected, the correlations with EQ visual analog and ACTIVLIM were lower (r = - 0.57 and - 0.48). ΔMGIIgen had an additional value on top of ΔMG-ADLgen in the prediction of ΔQMGgen (B = 0.54, p = 0.01).
The MGII score was cross-culturally validated in a Dutch cohort of MG patients. MGII had a higher sensitivity for generalized weakness than MG-ADL.
最近开发的重症肌无力损伤指数（MGII）是一种很有前途的衡量标准，因为与其他 MG 衡量标准相比，它的地板效应更小，对治疗效果的反应相对更有效。本研究旨在验证 MGII 在荷兰 MG 患者队列中的有效性，并分析 MGII 相对于 MG-ADL 对全身无力变化的敏感性。
我们分析了（广义项目）MGII、定量重症肌无力（QMG）、重症肌无力日常生活活动（MG-ADL）、EQ-5D 视觉模拟、重症肌无力综合评分（MGC）和 ACTIVLIM（一个侧重于全身无力的 ADL 问卷）评分在 99 例前瞻性 MG 患者队列中。我们研究了 MGII 与其他结果衡量标准之间的相关性。我们使用广义线性模型来评估在个体患者的 QMGgen 变化（Δ）中，MGIIgen 是否具有超过 MG-ADLgen 的额外敏感性。
MGII 的地板效应（4%）低于 QMG（6%）、MG-ADL（11%）和 MGC（16%）。MGII 与 QMG（r=0.68）、MG-ADL（r=0.83）和 MGC（r=0.74）相关性良好。不出所料，与 EQ 视觉模拟和 ACTIVLIM 的相关性较低（r=-0.57 和-0.48）。在预测 QMGgen 的Δ变化时，MGIIgen 的Δ值比 MG-ADLgen 的Δ值具有额外的价值（B=0.54，p=0.01）。
MGII 评分在荷兰 MG 患者队列中进行了跨文化验证。MGII 对全身无力的敏感性高于 MG-ADL。
