scholarly journals Validation of the Italian version of the Myasthenia Gravis Impairment Index (MGII)

Author(s):  
Francesca Pasqualin ◽  
Carolina Barnett ◽  
Silvia Vittoria Guidoni ◽  
Elisa Albertini ◽  
Mario Ermani ◽  
...  

Abstract Objective To validate the Italian version of the Myasthenia Gravis Impairment Index (MGII). Introduction MGII is a recent promising measure developed for MG patient evaluation. It includes a clinical severity evaluation and a patient-reported questionnaire. It has been developed in English and has demonstrated feasibility, reliability, and construct validity. Recently, its Dutch translation has been validated. Methods MGII was translated to Italian with a multi-step forward process. We assessed correlations with the following scores: Istituto Nazionale Carlo Besta score for Myasthenia Gravis (INCB-MG), the MG Activities of Daily Living (MG-ADL), the Myasthenia Gravis Composite (MGC), the Quality of Life 15 for Myasthenia Gravis (QOL15-MG), and the Myasthenia Gravis Disability (MGDIS). We also assessed differences in MGII scores by disease severity with the ANOVA Kruskal–Wallis test. Results One hundred forty-one patients were enrolled. The mean MGII total score was 13.3 ± 11.9 (range 0–49), with a mean ocular subscore of 3.7 ± 4.7 and a mean MGII generalized subscore of 9.6 ± 9.0. As expected, the MGII had a good correlation with the other severity scores. The MGII had a lower floor effect (3.5%) than the other measures. Twenty-five patients were assessed in follow-up; as expected, the MGII change scores had moderate correlations with change in other MG severity measures and lower correlations with quality of life measures. Conclusions The MGII score was cross-culturally validated in an Italian cohort of MG patients. We confirmed its lower floor effect and the correlations with other MG measures including INCB-MG that was not evaluated in previous studies.

2019 ◽  
Vol 34 (9) ◽  
pp. 627-635 ◽  
Author(s):  
Abduraheem Mohamed ◽  
Clement Leung ◽  
Louise Hitchman ◽  
Tom Wallace ◽  
George Smith ◽  
...  

Introduction Endovenous mechanochemical ablation (MOCA) is an increasingly popular non-thermal non-tumescent technique used to treat axial reflux in patients with superficial venous incompetence. However, the optimal management of varicose tributaries following this technique is unknown and may impact on patient outcomes. This study compares MOCA with concomitant phlebectomy (MOCAP) versus ablation with sequential phlebectomy if required (MOCAS). Methods Patients with symptomatic Comprehensive Classification System for Chronic Venous Disorders (CEAP C2–C6) unilateral axial reflux were studied. Patient choice determined whether concomitant treatment of varicosities was carried out. The primary outcome was the Aberdeen Varicose Veins Questionnaire (AVVQ) at one year. Secondary outcomes included: Venous Clinical Severity Scores (VCSS), EuroQol 5-Domain quality of life scores, complications, procedure duration, procedural and post-operative pain scores and need for secondary procedures. Outcomes were assessed at baseline and then one week, six weeks, six months and one year post intervention. Results Fifty patients underwent MOCAP and 33 patients MOCAS. The two groups were comparable at baseline. MOCAP was associated with lower (better) AVVQ scores at six weeks (3.4 (0.5–6.0) vs. 6.1 (1.8–12.1); P = 0.009) and at six months (1.6 (0.0–4.5) vs. 3.34 (1.8–8.4); P = 0.009) but by one year the difference was no longer statistically significant (1.81 (0.0–4.5) vs. 3.81 (0.2–5.3); P = 0.099). MOCAP was associated with longer procedural duration (45 min (36–56) vs. 30 min (25–37); P < 0.001) and higher maximal periprocedural pain (31 (21–59) vs. 18 (7–25); P = 0.001). VCSS at all time points were lower in favour of MOCAP (0 (0–1) vs. 1 (0–3); P < 0.001). MOCAP was associated with fewer episodes of clinically significant thrombophlebitis (6 of 50 (12%) vs. 10 of 33 (30%); P = 0.039) and lower numbers of secondary procedures (2 (4%) vs. 6 (18%); P = 0.032). Conclusion Concomitant treatment of tributary varicosities following MOCA improves quality of life and clinical severity, while reducing rates of re-intervention and post-operative thrombophlebitis compared to sequential treatment. The penalty is a modest increase in procedural duration and discomfort. Further evidence from longer-term follow-up is needed.


2020 ◽  
pp. 026835552094729
Author(s):  
Yasin Ay ◽  
Esra Gunes ◽  
Sevket Tuna Turkkolu ◽  
Emre Selcuk ◽  
Muhittin Calim ◽  
...  

Objectives To compare traditional surgery with two minimally invasive endo-venous procedures in terms of their long-term effect on the quality of life in great saphenous vein insufficiency (GSV). Method This prospective observational study included 217 patients that underwent surgical stripping (n = 62), radiofrequency ablation (n = 70), or cyanoacrylate embolization (n = 85) for the treatment of GSV insufficiency. Venous Clinical Severity Score (VCSS) assessments were made, 36-item Short-Form Health Survey (SF-36) questionnaire and Chronic Venous Insufficiency quality of life Questionnaire (CIVIQ-14) were administered, before and 1 year after the treatments. Results Surgical stripping group had significantly higher closure rates than the other groups (p < 0.05). At 12 months, decrease in VCSS scores was less pronounced in the cyanoacrylate embolization group when compared to the other two groups (p < 0.05). Improvement in CIVIQ-14 scores was better in the radiofrequency ablation group when compared to the cyanoacrylate embolization group (p < 0.05). Surgical stripping or radiofrequency ablation groups performed better on several domains of SF-36, when compared to the cyanoacrylate embolization group. Conclusions Surgical stripping and radiofrequency ablation seem to provide a better quality of life results at one year in patients undergoing treatment for GSV insufficiency.


Vascular ◽  
2011 ◽  
Vol 19 (5) ◽  
pp. 262-268 ◽  
Author(s):  
A M Conway ◽  
I M Nordon ◽  
R J Hinchliffe ◽  
M M Thompson ◽  
I M Loftus

The objective of this paper is to explore patterns of incompetence and disease distribution in patients with chronic venous disorders and to correlate this with CEAP (Clinical, Etiologic, Anatomic and Pathologic) classification and presenting symptoms to determine which features of chronic venous disorder (CVD) could be used to guide a patient pathway for referral and treatment. Consecutive patients attending a one-stop venous clinic at a university teaching hospital were recruited over a 12-month period. Patients were clinically assessed, assigned CEAP scores, duplex-scanned and categorized. Data were analyzed to identify associations between symptomatology and disease. Four hundred twenty-four limbs were divided into groups A (C2–3) (339) and B (C4–6) (85). The number of men, mean patient age, varicose vein diameter and quality-of-life score (Aberdeen Varicose Vein Questionnaire – AVVS) were significantly higher in group B ( P < 0.01). Ache occurred more commonly in group A and in women ( P < 0.01). Ache and pain were seen more frequently with saphenofemoral junction reflux ( P < 0.05). Group A women were more likely to be offered surgical intervention while men were managed conservatively ( P < 0.05). In conclusion, CVD symptoms are independent of disease severity assessed by CEAP score. Advanced disease is associated with larger venous diameters, older age and corresponds to a poorer quality of life. Objective markers such as CEAP, Venous Clinical Severity Score and AVVS should be used in determining a patient pathway for referral and treatment of CVD.


2017 ◽  
Vol 56 (4) ◽  
pp. 716-720 ◽  
Author(s):  
Alberto Raggi ◽  
Matilde Leonardi ◽  
Roberta Ayadi ◽  
Carlo Antozzi ◽  
Lorenzo Maggi ◽  
...  

2015 ◽  
Vol 31 (5) ◽  
pp. 289-296 ◽  
Author(s):  
Amanda C. Shepherd ◽  
Marta Ortega-Ortega ◽  
Manj S. Gohel ◽  
David Epstein ◽  
Louise C. Brown ◽  
...  

Objectives: Although the clinical benefits of endovenous thermal ablation are widely recognized, few studies have evaluated the health economic implications of different treatments. This study compares 6-month clinical outcomes and cost-effectiveness of endovenous laser ablation (EVLA) compared with radiofrequency ablation (RFA) in the setting of a randomized clinical trial.Methods: Patients with symptomatic primary varicose veins were randomized to EVLA or RFA and followed up for 6 months to evaluate clinical improvements, health related quality of life (HRQOL) and cost-effectiveness.Results: A total of 131 patients were randomized, of which 110 attended 6-month follow-up (EVLA n = 54; RFA n = 56). Improvements in quality of life (AVVQ and SF-12v2) and Venous Clinical Severity Scores (VCSS) achieved at 6 weeks were maintained at 6 months, with no significant difference detected between treatment groups. There were no differences in treatment failure rates. There were small differences in favor of EVLA in terms of costs and 6-month HRQOL but these were not statistically significant. However, RFA is associated with less pain at up to 10 days.Conclusions: EVLA and RFA result in comparable and significant gains in quality of life and clinical improvements at 6 months, compared with baseline values. EVLA is more likely to be cost-effective than RFA but absolute differences in costs and HRQOL are small.


SLEEP ◽  
2021 ◽  
Vol 44 (Supplement_2) ◽  
pp. A205-A206
Author(s):  
Mohanad AlGaeed ◽  
Tarrant McPherson ◽  
Ikjae Lee ◽  
Michelle Feese ◽  
Inmaculada Aban ◽  
...  

Abstract Introduction Restless legs syndrome (RLS) is a sensori-motor disorder characterized by an urge to move the limbs during inactivity alleviated at least partially by walking/stretching. By contrast, myasthenia gravis (MG) is a neuromuscular disease with fluctuating weakness aggravated by continued muscle activity. Only a few studies addressed the prevalence of RLS in MG patients with limitations related to small sample size and/or usage of non-validated RLS screening tools. The aim of this study was to revisit the prevalence and impact of RLS in a large sample of MG patients using the validated 13-item short-form Cambridge-Hopkins diagnostic questionnaire for RLS (CH-RLSq13). Methods The MG foundation of America patient registry was used to survey MG patients. Only patients aged ≥18 years, residing in the USA, and who answered “yes” to the question “Has your doctor diagnosed you with MG?” were included in this study. A survey including the CH-RLSq13, demographic information, disease related history, and patient reported outcomes including the MG15-item Quality of Life (MG-QOL15) and the MG-Activities of Daily Living (MG-ADL) instruments was sent to MG registry participants as part of the semi-annual follow up. Results A total of 630 MG patients (age: 62.8±13.2; 54.9% Women; 94.6% White) completed the survey and met eligibility criteria (22% of patients receiving the survey). The prevalence of RLS was 14.8% (93/630). Clinically significant RLS (moderately/extremely distressing RLS ≥2–3 days/week) was present in 53 (8.4%) MG patients. MG patients with (versus without) RLS were significantly younger (p=0.0061), more women (p=0.0440), with higher (worse) depression (p&lt;0.0001), MG-ADL (p=0.0001), and MG-QOL15 (p&lt;0.0001) scores. Conclusion Clinically significant RLS is prevalent in MG patients and is associated with a negative impact on mood, daily activities, and quality of life. Therefore, from a clinical practice it seems warranted to screen for RLS in MG patients. Support (if any) This study was not funded.


2016 ◽  
Vol 31 (1_suppl) ◽  
pp. 99-105 ◽  
Author(s):  
Fabio S Catarinella ◽  
Fred HM Nieman ◽  
Cees HA Wittens

Introduction Quality-of-life and severity scores are both popular measures in medicine. For deep venous obstruction, the VEINES-QOL/Sym and venous clinical severity score (VCSS) are widely used. Combining a patient-reported outcome with a clinical severity score should give a more sensitive outcome for treatment results. To establish and compare their suitability for deep venous disease, we compared the outcomes of both scores in a group of patients who were interventionally treated for deep venous disease. Methods The venous clinical severity scores and VEINES-QOL/Sym scores of a group of patients who had received interventional treatment for deep venous obstruction more than 12 months ago were compared at T0 and T12. Results Both the Spearman’s rho and Pearson’s r show a very weak, negative correlation (statistically significant ( p ≤ 0.05)), between the venous clinical severity score and VEINES-QOL at T12 and between the venous clinical severity score and the VEINES-SYM at both T0 and T12. T0 VCSS-VSYM: rho = −0.219 ( p = 0.052), r = −0.236 ( p = 0.037), T12 VCSS-VQOL: rho = −0.459 ( p = 0.007), r = −0.379 ( p = 0.030), T12 VCSS-VSYM: rho = −0.463 ( p = 0.007), r = −0.432 ( p = 0.012). This negative correlation was not statistically ( p ≥ 0.05) confirmed for T0 VCSS-VSYM. Conclusion The physician-scored venous clinical severity score of patients treated for deep venous obstruction does not correlate well with their self-reported quality-of-life and symptom scores.


Author(s):  
Sameah Haider ◽  
Martin J B Taphoorn ◽  
Katharine J Drummond ◽  
Tobias Walbert

Abstract Meningiomas are the most common primary intracranial tumor in adults. Although frequently histologically benign, the clinical severity of a lesion may range from being asymptomatic to causing severe impairment of global function and well-being. The diversity of intracranial locations and clinical phenotypes poses a challenge when studying functional impairments, however, more recent attention to patient-reported outcomes and health-related quality of life (HRQOL) have helped to improve our understanding of how meningioma may impact a patient’s life. Treatment strategies such as observation, surgery, radiation, or a combination thereof have been examined to ascertain their contributions to symptoms, physical and cognitive functioning, disability, and general aspects of daily functioning. This review explores the multidimensional nature of HRQOL and how patients may be influenced by meningiomas and their treatment. Overall, treatment of symptomatic meningiomas is associated with improved HRQOL, cognitive functioning, and seizure control while tumor size, location, histologic grade, and epileptic burden are associated with worse HRQOL.


2018 ◽  
Vol 25 (4) ◽  
pp. 140-151
Author(s):  
Markus A. Wirtz ◽  
Matthias Morfeld ◽  
Elmar Brähler ◽  
Andreas Hinz ◽  
Heide Glaesmer

Abstract. The association between health-related quality of life (HRQoL; Short-Form Health Survey-12; SF-12) and patient-reported morbidity-related symptoms measured by the Patient Health Questionnaire-15 (PHQ-15) is analyzed in a representative sample of older people in the general German population. Data from 1,659 people aged 60 to 85 years were obtained. Latent class analysis identified six classes of patients, which optimally categorize clusters of physical symptoms the participants reported: musculoskeletal impairments (39.8%), healthy (25.7%), musculoskeletal and respiratory/cardiac impairments (12.8%), musculoskeletal and respiratory impairments, along with bowel and digestion problems (12.9%), general impairments (4.9%), and general impairments with no bowel and digestion problems (4.8%). The participants’ SF-12 Physical Health Scores (η2 = .39) and their Mental Health Scores (η2 = .28) are highly associated with these latent classes. These associations remain virtually identical after controlling for age. The results provide evidence that profiles of patient-reported physical impairments correspond strongly with reduced HRQoL independently from aging processes.


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