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Expert consensus recommendations for improving and standardising the assessment of patients with generalised myasthenia gravis.
Meisel, Andreas; Saccà, Francesco; Spillane, Jennifer; Vissing, John.
Afiliação
  • Meisel A; Department of Neurology with Experimental Neurology, Neuroscience Clinical Research Center, Charité Universitätsmedizin Berlin, Berlin, Germany.
  • Saccà F; GENESIS Department, Federico II University of Naples, Naples, Italy.
  • Spillane J; National Hospital for Neurology and Neurosurgery, UCLH NHS Foundation Trust, London, UK.
  • Vissing J; Copenhagen Neuromuscular Center, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark.
Eur J Neurol ; 31(7): e16280, 2024 Jul.
Article em En | MEDLINE | ID: mdl-38523419
ABSTRACT

BACKGROUND:

Regular and consistent disease assessment could provide a clearer picture of burden in generalised myasthenia gravis (gMG) and improve patient care; however, the use of assessment tools in practice lacks standardisation. This modified Delphi approach was taken to review current evidence on assessment tool use in gMG and develop expert-derived consensus recommendations for good practice.

METHODS:

A European expert panel of 15 experienced gMG neurologists contributed to development of this consensus, four of whom formed a lead Sub-committee. The PICO (Population, Intervention, Control, Outcomes) framework was used to define six clinical questions on gMG assessment tools, a systematic literature review was conducted, and evidence-based statements were developed. According to a modified Delphi voting process, consensus was reached when ≥70% of the experts rated agreement with a statement as ≥8 on a scale of 1-10.

RESULTS:

Eighteen expert- and evidence-based consensus statements based on six themes were developed. Key recommendations include consistent use of the Myasthenia Gravis Activities of Daily Living score (MG-ADL) across clinical settings, followed by a simple question (e.g., Patient Acceptable Symptom State [PASS]) or scale to determine patient satisfaction in clinical practice; use of a Quantitative Myasthenia Gravis [QMG] or quality of life [QoL] assessment when the MG-ADL indicates disease worsening; and consideration of symptom state to determine the timing and frequency of recommended assessments. Expert panel consensus was reached on all 18 statements after two voting rounds.

CONCLUSIONS:

This process provided evidence- and expert consensus-based recommendations for the use of objective and subjective assessment tools across gMG research and care to improve management and outcomes for patients.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Técnica Delphi / Consenso / Miastenia Gravis Limite: Humans Idioma: En Ano de publicação: 2024 Tipo de documento: Article

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Técnica Delphi / Consenso / Miastenia Gravis Limite: Humans Idioma: En Ano de publicação: 2024 Tipo de documento: Article