Doets, Alex Y. and Lingsma, Hester F. and Walgaard, Christa and Islam, Badrul and Papri, Nowshin and Davidson, Amy and Yamagishi, Yuko and Kusunoki, Susumu and Dimachkie, Mazen M. and Waheed, Waqar and Kolb, Noah and Islam, Zhahirul and Mohammad, Quazi Deen and Harbo, Thomas and Sindrup, Soren H. and Chavada, Govindsinh and Willison, Hugh J. and Casasnovas, Carlos and Bateman, Kathleen and Miller, James A. L. and van den Berg, Bianca and Verboon, Christine and Roodbol, Joyce and Leonhard, Sonja E. and Benedetti, Luana and Kuwabara, Satoshi and Van den Bergh, Peter and Monges, Soledad and Marfia, Girolama A. and Shahrizaila, Nortina and Galassi, Giuliana and Pereon, Yann and Burmann, Jan and Kuitwaard, Krista and Kleyweg, Ruud P. and Marchesoni, Cintia and Tous, Maria J. Sedano and Querol, Luis and Illa, Isabel and Wang, Yuzhong and Nobile-Orazio, Eduardo and Rinaldi, Simon and Schenone, Angelo and Pardo, Julio and Vermeij, Frederique H. and Lehmann, Helmar C. and Granit, Volkan and Cavaletti, Guido and Gutierrez-Gutierrez, Gerardo and Barroso, Fabio A. and Visser, Leo H. and Katzberg, Hans D. and Dardiotis, Efthimios and Attarian, Shahram and van der Kooi, Anneke J. and Eftimov, Filip and Wirtz, Paul W. and Samijn, Johnny P. A. and Gilhuis, H. Jacobus and Hadden, Robert D. M. and Holt, James K. L. and Sheikh, Kazim A. and Karafiath, Summer and Vytopil, Michal and Antonini, Giovanni and Feasby, Thomas E. and Faber, Catharina G. and Gijsbers, Cees J. and Busby, Mark and Roberts, Rhys C. and Silvestri, Nicholas J. and Fazio, Raffaella and van Dijk, Gert W. and Garssen, Marcel P. J. and Straathof, Chiara S. M. and Gorson, Kenneth C. and Jacobs, Bart C. and Consortium, IGOS (2022) Predicting outcome in Guillain-Barre syndrome international validation of the modified Erasmus GBS Outcome Score. Neurology, 98 (5). E518-E532. ISSN 0028-3878, DOI https://doi.org/10.1212/WNL.0000000000013139.
Full text not available from this repository.Abstract
The clinical course and outcome of the Guillain-Barre syndrome (GBS) are diverse and vary among regions. The modified Erasmus GBS Outcome Score (mEGOS), developed with data from Dutch patients, is a clinical model that predicts the risk of walking inability in patients with GBS. The study objective was to validate the mEGOS in the International GBS Outcome Study (IGOS) cohort and to improve its performance and region specificity. Methods We used prospective data from the first 1,500 patients included in IGOS, aged >= 6 years and unable to walk independently. We evaluated whether the mEGOS at entry and week 1 could predict the inability to walk unaided at 4 and 26 weeks in the full cohort and in regional subgroups, using 2 measures for model performance: (1) discrimination: area under the receiver operating characteristic curve (AUC) and (2) calibration: observed vs predicted probability of being unable to walk independently. To improve the model predictions, we recalibrated the model containing the overall mEGOS score, without changing the individual predictive factors. Finally, we assessed the predictive ability of the individual factors. Results For validation of mEGOS at entry, 809 patients were eligible (Europe/North America n = 677], Asia n = 76], other n = 56]), and 671 for validation of mEGOS at week 1 (Europe/North America n = 563], Asia n = 65], other n = 43]). AUC values were >0.7 in all regional subgroups. In the Europe/North America subgroup, observed outcomes were worse than predicted; in Asia, observed outcomes were better than predicted. Recalibration improved model accuracy and enabled the development of a region-specific version for Europe/North America (mEGOS-Eu/NA). Similar to the original mEGOS, severe limb weakness and higher age were the predominant predictors of poor outcome in the IGOS cohort. Discussion mEGOS is a validated tool to predict the inability to walk unaided at 4 and 26 weeks in patients with GBS, also in countries outside the Netherlands. We developed a region-specific version of mEGOS for patients from Europe/North America. Classification of Evidence This study provides Class II evidence that the mEGOS accurately predicts the inability to walk unaided at 4 and 26 weeks in patients with GBS.
| Item Type: | Article |
|---|---|
| Funders: | GBS-CIDP Foundation International, gain, Erasmus University Medical Centre, Glasgow University, CSL Behring |
| Uncontrolled Keywords: | Intravenous immunoglobulin; Poor-prognosis; Models |
| Subjects: | R Medicine |
| Divisions: | Faculty of Medicine |
| Depositing User: | Ms. Juhaida Abd Rahim |
| Date Deposited: | 23 Aug 2022 04:17 |
| Last Modified: | 26 Aug 2022 00:58 |
| URI: | http://eprints.um.edu.my/id/eprint/33399 |
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