重症肌无力临床常用测评量表的介绍与应用
|
摘要
重症肌无力(MG)临床测评量表作为MG病情的量化工具,应用贯穿于MG的治疗和随访全程。近年来,随着循证医学模式的发展及大数据在临床医学领域内的应用,MG测评量表在临床研究和工作中进行定量肌无力程度、评估生活质量、评价药物疗效、监测病情变化及指导随访治疗等方面发挥了重大作用。细数国内外开发出的各种MG测评量表,评价角度多样,内容全面详实,具有很高的实用价值。但由于数量众多,优势不一,给研究人员和临床医生的应用选择造成了困难。为此,文中对近年来国内外临床研究中常用的MG测评量表进行分类介绍,并对量表信度和效度进行总结,旨在为广大临床研究人员和临床医生选择合适的量表提供理论和实践依据。
As a quantitative tool for myasthenia gravis( MG),the scale has been used throughout the treatment and follow-up of MG. In clinical research and clinical work,the outcome measures have played a significant role in quantifying the degree of muscle weakness,assessing quality of life,evaluating the efficacy of drugs,monitoring the changes of disease and guiding follow-up treatment. Especially in recent years,with the development of the evidence-based medicine model and the application of big data in the field of clinical medicine,MG assessment scales play an increasingly important role in clinical research and clinical work. The various outcome measures developed at home and abroad have a high practical value with diverse evaluation angles,comprehensive and detailed contents. However,due to the large number and different advantages,it is difficult for clinical researchers and clinicians to choose and apply. This paper classified and introduced various MG assessment scales commonly used in clinical research in recent years,and summarized their reliability and validity,which provides theoretical and practical basis for clinical researchers and clinicians to select appropriate scales.
As a quantitative tool for myasthenia gravis( MG),the scale has been used throughout the treatment and follow-up of MG. In clinical research and clinical work,the outcome measures have played a significant role in quantifying the degree of muscle weakness,assessing quality of life,evaluating the efficacy of drugs,monitoring the changes of disease and guiding follow-up treatment. Especially in recent years,with the development of the evidence-based medicine model and the application of big data in the field of clinical medicine,MG assessment scales play an increasingly important role in clinical research and clinical work. The various outcome measures developed at home and abroad have a high practical value with diverse evaluation angles,comprehensive and detailed contents. However,due to the large number and different advantages,it is difficult for clinical researchers and clinicians to choose and apply. This paper classified and introduced various MG assessment scales commonly used in clinical research in recent years,and summarized their reliability and validity,which provides theoretical and practical basis for clinical researchers and clinicians to select appropriate scales.
引文
[1] Sanders DB, Wolfe GI, Benatar M, et al. International consensus guidance for management of myasthenia gravis Executive summary[J]. Neurology, 2016, 87:419-425
[2]王潇,张爱迪,严谨,等.大数据在医疗卫生中的应用前景[J].中国全科医学,2015:113-115
[3] Barohn RJ, Mcintire D, Herbelin L, et al. Reliability testing of the quantitative myasthenia gravis score[J]. Ann N Y Acad Sci,1998, 841:769-772
[4] Besinger UA, Toyka KV, Homberg M, et al. Myasthenia gravis:long-term correlation of binding and bungarotoxin blocking antibodies against acetylcholine receptors with changes in disease severity[J]. Neurology, 1983, 33:1316-1321
[5] Tindall RS, Rollins JA, Phillips JT, et al. Preliminary results of a double-blind, randomized, placebo-controlled trial of cyclosporine in myasthenia gravis[J]. N Engl J Med, 1987, 316:719-724
[6] Jaretzki A, Barohn RJ, Ernstoff RM, et al. Myasthenia gravis:recommendations for clinical research standards. Task Force of the Medical Scientific Advisory Board of the Myasthenia Gravis Foundation of America[J]. Neurology, 2000, 55:16-23
[7] Sharshar T, Chevret S, Mazighi M, et al. Validity and reliability of two muscle strength scores commonly used as endpoints in assessing treatment of myasthenia gravis[J]. J Neurol, 2000,247:286-290
[8] Bedlack RS, Simel DL, Bosworth H, et al. Quantitative myasthenia gravis score:assessment of responsiveness and longitudinal validity[J]. Neurology, 2005, 64:1968-1970
[9] Katzberg HD, Barnett C, Merkies IS, et al. Minimal clinically important difference in myasthenia gravis:outcomes from a randomized trial[J]. Muscle Nerve, 2014, 49:661-665
[10]Bhanushali MJ, Wuu J, Benatar M, et al. Treatment of ocular symptoms in myasthenia gravis[J]. Neurology, 2008, 71:1335-1341
[11]Zinman L, Bril V. IVIG treatment for myasthenia gravis:effectiveness, limitations, and novel therapeutic strategies[J].Ann N Y Acad Sci, 2008,1132:264-270
[12]Meriggioli MN, Ciafaloni E, Alhayk KA, et al. Mycophenolate mofetil for myasthenia gravis:an analysis of efficacy, safety, and tolerability[J]. Neurology, 2003, 61:1438-1440
[13]Nagane Y, Utsugisawa K, Obara D, et al. Efficacy of low-dose FK506 in the treatment of Myasthenia gravis--a randomized pilot study[J]. Eur Neurol, 2005, 53:146-150
[14]Ponseti JM, Azem J, Fort JM, et al. Benefits of FK506(tacrolimus)for residual, cyclosporin-and prednisone-resistant myasthenia gravis:one-year follow-up of an open-label study[J].Clin Neurol Neurosurg,2005, 107:187-190
[15]Rowin J, Meriggioli MN, Tüzün E, et al. Etanercept treatment in corticosteroid-dependent myasthenia gravis[J]. Neurology,2004, 63:2390-2392
[16]Wolfe GI, Kaminski HJ, Aban IB, et al. Randomized trial of thymectomy in myasthenia gravis[J]. N Engl J Med, 2016,375:511-522
[17]Howard JF, Barohn RJ, Cutter G, et al. A randomized, doubleblind, placebo-controlled phase II study of eculizumab in patients with refractory generalized myasthenia gravis[J]. Muscle Nerve, 2013, 48:76-84
[18]Sanders DB, Tucker-Lipscomb B, Massey JM. A simple manual muscle test for myasthenia gravis:validation and comparison with the QMG score[J]. Ann N Y Acad Sci, 2003, 998:440-444
[19]Wolfe GI, Barohn RJ, Sanders DB, et al. Comparison of outcome measures from a trial of mycophenolate mofetil in myasthenia gravis[J]. Muscle Nerve, 2008, 38:1429-1433
[20]Meriggioli MN, Ciafaloni E, Al-Hayk KA, et al. Mycophenolate mofetil for myasthenia gravis:an analysis of efficacy, safety, and tolerability[J]. Neurology, 2003, 61:1438-1440
[21]Ciafaloni E, Massey JM, Tucker-Lipscomb B, et al. Mycophenolate mofetil for myasthenia gravis:an open-label pilot study[J].Neurology, 2001, 56:97-99
[22]Pasnoor M, He J, Herbelin L, et al. A randomized controlled trial of methotrexate for patients with generalized myasthenia gravis[J]. Neurology, 2016, 87:57-64
[23]Anderson D, Phan C, Johnston WS, et al. Rituximab in refractory myasthenia gravis:a prospective, open-label study with long-term follow-up[J]. Ann Clin Transl Neurol, 2016, 3:552-555
[24]王秀云,许贤豪,孙宏,等.重症肌无力病人的临床绝对评分法和相对评分法[J].中华神经科杂志, 1997, 30:87-90
[25]彭丹涛,许贤豪,佘子瑜.新斯的明试验改良结果判定法研究[J].中国神经免疫学和神经病学杂志, 2007, 14:1-3
[26]中华医学会神经病学分会神经免疫分组,中国免疫学会神经免疫分会.中国重症肌无力诊断和治疗指南2015[J].中华神经科杂志, 2015, 48:934-940
[27]刘爱东,李柱一,张金妮,等.重症肌无力患者病情变化对单纤维肌电图jitter值的影响[J].中国临床神经科学, 2005,13:348-351.
[28]刘卫彬,门丽娜,陈振光,等.胸腺扩大切除术治疗重症肌无力远期疗效及影响因素分析[J].中华医学杂志, 2006, 86:3182-3185
[29]承欧梅,陈晓文,晏勇.大剂量激素冲击联合小剂量血浆置换治疗重症肌无力的疗效[J].中国临床神经科学, 2001, 9:378-380
[30]黄莹,赵重波,周磊,等.短程大剂量甲泼尼龙治疗难治性眼肌型重症肌无力的临床观察[J].中国临床神经科学,2012, 20:159-163
[31]Wolfe GI, Herbelin L, Nations SP, et al. Myasthenia gravis activities of daily living profile[J]. Neurology, 1999, 52:1487-1489
[32]Muppidi S, Wolfe GI, Conaway M, et al. MG-ADL:still a relevant outcome measure[J]. Muscle Nerve, 2011, 44:727-731
[33]Howard JF, Freimer M, O'Brien F, et al. QMG and MG-ADL correlations:Study of eculizumab treatment of myasthenia gravis[J]. Muscle Nerve, 2017, 56:328-330
[34]Howard JF Jr, Utsugisawa K, Benatar M, et al. Safety and efficacy of eculizumab in anti-acetylcholine receptor antibodypositive refractory generalised myasthenia gravis(REGAIN):a phase 3, randomised, double-blind, placebo-controlled, multicentre study[J]. Lancet Neurol, 2017, 16:976-986
[35]Howard JF Jr, O'Brien F, Wang JJ, et al. Distinct representation of muscle weakness in QMG and MG-ADL–Authors'reply[J]. Lancet Neurology, 2018, 17:205-206
[36]Wolfe GI, Barohn RJ, Foster BM, et al. Randomized,controlled trial of intravenous immunoglobulin in myasthenia gravis[J]. Muscle Nerve, 2002, 26:549-552
[37]Wolfe GI, Kaminski HJ, Jaretzki A 3rd, et al. Development of a thymectomy trial in nonthymomatous myasthenia gravis patients receiving immunosuppressive therapy[J]. Ann N Y Acad Sci,2003, 998:473-480
[38]Takamori M, Motomura M, Kawaguchi N, et al. Anti-ryanodine receptor antibodies and FK506 in myasthenia gravis[J].Neurology, 2004, 62:1894-1896
[39]Kawaguchi N, Yoshiyama Y, Nemoto Y, et al. Low-dose tacrolimus treatment in thymectomised and steroid-dependent myasthenia gravis[J]. Curr Med Res Opin, 2004, 20:1269-1273
[40]Burns TM, Conaway MR, Cutter GR, et al. Less is more, or almost as much:a 15-item quality-of-life instrument for myasthenia gravis[J]. Muscle Nerve, 2008, 38:957-963
[41]Mullins LL, Carpentier MY, Paul RH, et al. Disease-specific measure of quality of life for myasthenia gravis.[J]. Muscle Nerve, 2008, 38:947-956
[42]Burns TM, Grouse CK, Wolfe GI, et al. The MG-QOL15 for following the health-related quality of life of patients with myasthenia gravis.[J]. Muscle Nerve, 2011, 43:14-18
[43]Lee I, Kaminski HJ, Xin H, et al. Gender and quality of life in myasthenia gravis patients from the myasthenia gravis foundation of America registry[J]. Muscle Nerve, 2018, doi:10. 1002/mus.26104.
[44]Burns TM, Grouse CK, Conaway MR, et al. Construct and concurrent validation of the MG-QOL15 in the practice setting[J]. Muscle Nerve, 2009, 41:219-226
[45]Burns TM, Grouse CK, Wolfe GI, et al. The MG-QOL15 for following the health-related quality of life of patients with myasthenia gravis[J]. Muscle Nerve, 2011, 43:14-18
[46]Masuda M, Utsugisawa K, Suzuki S, et al. The MG-QOL15Japanese version:validation and associations with clinical factors[J]. Muscle Nerve, 2012, 46:166-173
[47]Ostovan VR, Fatehi F, Davoudi F, et al. Validation of the 15-item myasthenia gravis quality of life questionnaire(MG-QOL15)Persian version[J]. Muscle Nerve, 2016, 54:65-70
[48]Birnbaum S, Ghout I, Demeret S, et al. Translation, crosscultural adaptation, and validation of the french version of the15-item Myasthenia Gravis Quality Of Life Scale[J]. Muscle Nerve 2017, 55:639-645
[49]Raggi A, Leonardi M, Ayadi R, et al. Validation of the italian version of the 15-item Myasthenia Gravis Quality-of-Life questionnaire[J]. Muscle Nerve, 2017, 56:716-720
[50]Strijbos E, Grtner FR, Verschuuren JJ, et al. Translation and validation of the 15-item Myasthenia Gravis Quality of life scale in Dutch[J]. Muscle Nerve, 2018, 57:206-211
[51]Burns TM, Conaway MR, Cutter GR, et al. Construction of an efficient evaluative instrument for Myasthenia Gravis:the MG composite[J]. Muscle Nerve, 2008, 38:1553-1562
[52]Burns TM, Conaway M, Sanders DB, et al. The MG Composite:A valid and reliable outcome measure for myasthenia gravis[J]. Neurology, 2010, 74:1434-1440
[53]Benatar M, Sanders DB, Burns TM, et al. Recommendations for myasthenia gravis clinical trials[J]. Muscle Nerve, 2012, 45:909-917
[54]Sadjadi R, Conaway M, Cutter G, et al. Psychometric evaluation of the myasthenia gravis composite using Rasch analysis[J].Muscle Nerve, 2012, 45:820-825
[55]Utsugisawa K, Suzuki S, Nagane Y, et al. Health-related quality-of-life and treatment targets in myasthenia gravis[J].Muscle Nerve, 2014, 50:493-500
[56]Vrinten C, Lipka AF, van Zwet EW, et al. Ephedrine as addon therapy for patients with myasthenia gravis:protocol for a series of randomised, placebo-controlled n-of-1 trials[J]. BMJ Open, 2015, 5:e007863
[57]Westerberg E, Molin CJ, Lindblad I, et al. Physical exercise in myasthenia gravis is safe and improves neuromuscular parameters and physical performance-based measures:A pilot study[J].Muscle Nerve, 2017, 56:207-214
[58]Alabdali M, Barnett C, Katzberg H, et al. Intravenous immunoglobulin as treatment for myasthenia gravis:current evidence and outcomes[J]. Expert Rev Clin Immunol, 2014, 10:1659-1665
[59]Vinge L, Andersen H.. Muscle strength and fatigue in newly diagnosed patients with myasthenia gravis[J]. Muscle Nerve,2016, 54:709-714
[60]Barnett C, Bril V, Kapral M, et al. Development and validation of the Myasthenia Gravis Impairment Index[J]. Neurology,2016, 87:879-886
[61]Barnett C, Bril V, Kapral M,, et al. Myasthenia Gravis Impairment Index:Responsiveness, meaningful change, and relative efficiency[J]. Neurology, 2017, 89:2357-2364
[62]Tran C, Bril V, Katzberg HD, et al. Fatigue is a relevant outcome in patients with myasthenia gravis[J]. Muscle Nerve,2018, 58:197-203
[63]Abraham A, Breiner A, Barnett C, et al. The utility of a single simple question in the evaluation of patients with myasthenia gravis[J]. Muscle Nerve, 2018, 57:240-244
[64]Burns TM. Using disease-specific, patient-reported measures in everyday clinic[J]. Neurology, 2016, 87:858-859
[2]王潇,张爱迪,严谨,等.大数据在医疗卫生中的应用前景[J].中国全科医学,2015:113-115
[3] Barohn RJ, Mcintire D, Herbelin L, et al. Reliability testing of the quantitative myasthenia gravis score[J]. Ann N Y Acad Sci,1998, 841:769-772
[4] Besinger UA, Toyka KV, Homberg M, et al. Myasthenia gravis:long-term correlation of binding and bungarotoxin blocking antibodies against acetylcholine receptors with changes in disease severity[J]. Neurology, 1983, 33:1316-1321
[5] Tindall RS, Rollins JA, Phillips JT, et al. Preliminary results of a double-blind, randomized, placebo-controlled trial of cyclosporine in myasthenia gravis[J]. N Engl J Med, 1987, 316:719-724
[6] Jaretzki A, Barohn RJ, Ernstoff RM, et al. Myasthenia gravis:recommendations for clinical research standards. Task Force of the Medical Scientific Advisory Board of the Myasthenia Gravis Foundation of America[J]. Neurology, 2000, 55:16-23
[7] Sharshar T, Chevret S, Mazighi M, et al. Validity and reliability of two muscle strength scores commonly used as endpoints in assessing treatment of myasthenia gravis[J]. J Neurol, 2000,247:286-290
[8] Bedlack RS, Simel DL, Bosworth H, et al. Quantitative myasthenia gravis score:assessment of responsiveness and longitudinal validity[J]. Neurology, 2005, 64:1968-1970
[9] Katzberg HD, Barnett C, Merkies IS, et al. Minimal clinically important difference in myasthenia gravis:outcomes from a randomized trial[J]. Muscle Nerve, 2014, 49:661-665
[10]Bhanushali MJ, Wuu J, Benatar M, et al. Treatment of ocular symptoms in myasthenia gravis[J]. Neurology, 2008, 71:1335-1341
[11]Zinman L, Bril V. IVIG treatment for myasthenia gravis:effectiveness, limitations, and novel therapeutic strategies[J].Ann N Y Acad Sci, 2008,1132:264-270
[12]Meriggioli MN, Ciafaloni E, Alhayk KA, et al. Mycophenolate mofetil for myasthenia gravis:an analysis of efficacy, safety, and tolerability[J]. Neurology, 2003, 61:1438-1440
[13]Nagane Y, Utsugisawa K, Obara D, et al. Efficacy of low-dose FK506 in the treatment of Myasthenia gravis--a randomized pilot study[J]. Eur Neurol, 2005, 53:146-150
[14]Ponseti JM, Azem J, Fort JM, et al. Benefits of FK506(tacrolimus)for residual, cyclosporin-and prednisone-resistant myasthenia gravis:one-year follow-up of an open-label study[J].Clin Neurol Neurosurg,2005, 107:187-190
[15]Rowin J, Meriggioli MN, Tüzün E, et al. Etanercept treatment in corticosteroid-dependent myasthenia gravis[J]. Neurology,2004, 63:2390-2392
[16]Wolfe GI, Kaminski HJ, Aban IB, et al. Randomized trial of thymectomy in myasthenia gravis[J]. N Engl J Med, 2016,375:511-522
[17]Howard JF, Barohn RJ, Cutter G, et al. A randomized, doubleblind, placebo-controlled phase II study of eculizumab in patients with refractory generalized myasthenia gravis[J]. Muscle Nerve, 2013, 48:76-84
[18]Sanders DB, Tucker-Lipscomb B, Massey JM. A simple manual muscle test for myasthenia gravis:validation and comparison with the QMG score[J]. Ann N Y Acad Sci, 2003, 998:440-444
[19]Wolfe GI, Barohn RJ, Sanders DB, et al. Comparison of outcome measures from a trial of mycophenolate mofetil in myasthenia gravis[J]. Muscle Nerve, 2008, 38:1429-1433
[20]Meriggioli MN, Ciafaloni E, Al-Hayk KA, et al. Mycophenolate mofetil for myasthenia gravis:an analysis of efficacy, safety, and tolerability[J]. Neurology, 2003, 61:1438-1440
[21]Ciafaloni E, Massey JM, Tucker-Lipscomb B, et al. Mycophenolate mofetil for myasthenia gravis:an open-label pilot study[J].Neurology, 2001, 56:97-99
[22]Pasnoor M, He J, Herbelin L, et al. A randomized controlled trial of methotrexate for patients with generalized myasthenia gravis[J]. Neurology, 2016, 87:57-64
[23]Anderson D, Phan C, Johnston WS, et al. Rituximab in refractory myasthenia gravis:a prospective, open-label study with long-term follow-up[J]. Ann Clin Transl Neurol, 2016, 3:552-555
[24]王秀云,许贤豪,孙宏,等.重症肌无力病人的临床绝对评分法和相对评分法[J].中华神经科杂志, 1997, 30:87-90
[25]彭丹涛,许贤豪,佘子瑜.新斯的明试验改良结果判定法研究[J].中国神经免疫学和神经病学杂志, 2007, 14:1-3
[26]中华医学会神经病学分会神经免疫分组,中国免疫学会神经免疫分会.中国重症肌无力诊断和治疗指南2015[J].中华神经科杂志, 2015, 48:934-940
[27]刘爱东,李柱一,张金妮,等.重症肌无力患者病情变化对单纤维肌电图jitter值的影响[J].中国临床神经科学, 2005,13:348-351.
[28]刘卫彬,门丽娜,陈振光,等.胸腺扩大切除术治疗重症肌无力远期疗效及影响因素分析[J].中华医学杂志, 2006, 86:3182-3185
[29]承欧梅,陈晓文,晏勇.大剂量激素冲击联合小剂量血浆置换治疗重症肌无力的疗效[J].中国临床神经科学, 2001, 9:378-380
[30]黄莹,赵重波,周磊,等.短程大剂量甲泼尼龙治疗难治性眼肌型重症肌无力的临床观察[J].中国临床神经科学,2012, 20:159-163
[31]Wolfe GI, Herbelin L, Nations SP, et al. Myasthenia gravis activities of daily living profile[J]. Neurology, 1999, 52:1487-1489
[32]Muppidi S, Wolfe GI, Conaway M, et al. MG-ADL:still a relevant outcome measure[J]. Muscle Nerve, 2011, 44:727-731
[33]Howard JF, Freimer M, O'Brien F, et al. QMG and MG-ADL correlations:Study of eculizumab treatment of myasthenia gravis[J]. Muscle Nerve, 2017, 56:328-330
[34]Howard JF Jr, Utsugisawa K, Benatar M, et al. Safety and efficacy of eculizumab in anti-acetylcholine receptor antibodypositive refractory generalised myasthenia gravis(REGAIN):a phase 3, randomised, double-blind, placebo-controlled, multicentre study[J]. Lancet Neurol, 2017, 16:976-986
[35]Howard JF Jr, O'Brien F, Wang JJ, et al. Distinct representation of muscle weakness in QMG and MG-ADL–Authors'reply[J]. Lancet Neurology, 2018, 17:205-206
[36]Wolfe GI, Barohn RJ, Foster BM, et al. Randomized,controlled trial of intravenous immunoglobulin in myasthenia gravis[J]. Muscle Nerve, 2002, 26:549-552
[37]Wolfe GI, Kaminski HJ, Jaretzki A 3rd, et al. Development of a thymectomy trial in nonthymomatous myasthenia gravis patients receiving immunosuppressive therapy[J]. Ann N Y Acad Sci,2003, 998:473-480
[38]Takamori M, Motomura M, Kawaguchi N, et al. Anti-ryanodine receptor antibodies and FK506 in myasthenia gravis[J].Neurology, 2004, 62:1894-1896
[39]Kawaguchi N, Yoshiyama Y, Nemoto Y, et al. Low-dose tacrolimus treatment in thymectomised and steroid-dependent myasthenia gravis[J]. Curr Med Res Opin, 2004, 20:1269-1273
[40]Burns TM, Conaway MR, Cutter GR, et al. Less is more, or almost as much:a 15-item quality-of-life instrument for myasthenia gravis[J]. Muscle Nerve, 2008, 38:957-963
[41]Mullins LL, Carpentier MY, Paul RH, et al. Disease-specific measure of quality of life for myasthenia gravis.[J]. Muscle Nerve, 2008, 38:947-956
[42]Burns TM, Grouse CK, Wolfe GI, et al. The MG-QOL15 for following the health-related quality of life of patients with myasthenia gravis.[J]. Muscle Nerve, 2011, 43:14-18
[43]Lee I, Kaminski HJ, Xin H, et al. Gender and quality of life in myasthenia gravis patients from the myasthenia gravis foundation of America registry[J]. Muscle Nerve, 2018, doi:10. 1002/mus.26104.
[44]Burns TM, Grouse CK, Conaway MR, et al. Construct and concurrent validation of the MG-QOL15 in the practice setting[J]. Muscle Nerve, 2009, 41:219-226
[45]Burns TM, Grouse CK, Wolfe GI, et al. The MG-QOL15 for following the health-related quality of life of patients with myasthenia gravis[J]. Muscle Nerve, 2011, 43:14-18
[46]Masuda M, Utsugisawa K, Suzuki S, et al. The MG-QOL15Japanese version:validation and associations with clinical factors[J]. Muscle Nerve, 2012, 46:166-173
[47]Ostovan VR, Fatehi F, Davoudi F, et al. Validation of the 15-item myasthenia gravis quality of life questionnaire(MG-QOL15)Persian version[J]. Muscle Nerve, 2016, 54:65-70
[48]Birnbaum S, Ghout I, Demeret S, et al. Translation, crosscultural adaptation, and validation of the french version of the15-item Myasthenia Gravis Quality Of Life Scale[J]. Muscle Nerve 2017, 55:639-645
[49]Raggi A, Leonardi M, Ayadi R, et al. Validation of the italian version of the 15-item Myasthenia Gravis Quality-of-Life questionnaire[J]. Muscle Nerve, 2017, 56:716-720
[50]Strijbos E, Grtner FR, Verschuuren JJ, et al. Translation and validation of the 15-item Myasthenia Gravis Quality of life scale in Dutch[J]. Muscle Nerve, 2018, 57:206-211
[51]Burns TM, Conaway MR, Cutter GR, et al. Construction of an efficient evaluative instrument for Myasthenia Gravis:the MG composite[J]. Muscle Nerve, 2008, 38:1553-1562
[52]Burns TM, Conaway M, Sanders DB, et al. The MG Composite:A valid and reliable outcome measure for myasthenia gravis[J]. Neurology, 2010, 74:1434-1440
[53]Benatar M, Sanders DB, Burns TM, et al. Recommendations for myasthenia gravis clinical trials[J]. Muscle Nerve, 2012, 45:909-917
[54]Sadjadi R, Conaway M, Cutter G, et al. Psychometric evaluation of the myasthenia gravis composite using Rasch analysis[J].Muscle Nerve, 2012, 45:820-825
[55]Utsugisawa K, Suzuki S, Nagane Y, et al. Health-related quality-of-life and treatment targets in myasthenia gravis[J].Muscle Nerve, 2014, 50:493-500
[56]Vrinten C, Lipka AF, van Zwet EW, et al. Ephedrine as addon therapy for patients with myasthenia gravis:protocol for a series of randomised, placebo-controlled n-of-1 trials[J]. BMJ Open, 2015, 5:e007863
[57]Westerberg E, Molin CJ, Lindblad I, et al. Physical exercise in myasthenia gravis is safe and improves neuromuscular parameters and physical performance-based measures:A pilot study[J].Muscle Nerve, 2017, 56:207-214
[58]Alabdali M, Barnett C, Katzberg H, et al. Intravenous immunoglobulin as treatment for myasthenia gravis:current evidence and outcomes[J]. Expert Rev Clin Immunol, 2014, 10:1659-1665
[59]Vinge L, Andersen H.. Muscle strength and fatigue in newly diagnosed patients with myasthenia gravis[J]. Muscle Nerve,2016, 54:709-714
[60]Barnett C, Bril V, Kapral M, et al. Development and validation of the Myasthenia Gravis Impairment Index[J]. Neurology,2016, 87:879-886
[61]Barnett C, Bril V, Kapral M,, et al. Myasthenia Gravis Impairment Index:Responsiveness, meaningful change, and relative efficiency[J]. Neurology, 2017, 89:2357-2364
[62]Tran C, Bril V, Katzberg HD, et al. Fatigue is a relevant outcome in patients with myasthenia gravis[J]. Muscle Nerve,2018, 58:197-203
[63]Abraham A, Breiner A, Barnett C, et al. The utility of a single simple question in the evaluation of patients with myasthenia gravis[J]. Muscle Nerve, 2018, 57:240-244
[64]Burns TM. Using disease-specific, patient-reported measures in everyday clinic[J]. Neurology, 2016, 87:858-859