Development of the clinical assessment scale in autoimmune encephalitis

Objective There is no scale for rating the severity of autoimmune encephalitis (AE). In this study, we aimed to develop a novel scale for rating severity in patients with diverse AE syndromes and to verify the reliability and validity of the developed scale. Methods The key items were generated by a...

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Vydané v:	Annals of neurology Ročník 85; číslo 3; s. 352 - 358
Hlavní autori:	Lim, Jung‐Ah, Lee, Soon‐Tae, Moon, Jangsup, Jun, Jin‐Sun, Kim, Tae‐Joon, Shin, Yong‐Won, Abdullah, Suhailah, Byun, Jung‐Ick, Sunwoo, Jun‐Sang, Kim, Keun Tae, Yang, Tae‐Won, Lee, Woo‐Jin, Moon, Hye‐Jin, Kim, Dong Wook, Lim, Byung Chan, Cho, Yong Won, Yang, Tae‐Ho, Kim, Hee Jin, Kim, Young‐Soo, Koo, Yong Seo, Park, Byeongsu, Jung, Keun‐Hwa, Kim, Manho, Park, Kyung‐Il, Jung, Ki‐Young, Chu, Kon, Lee, Sang Kun
Médium:	Journal Article
Jazyk:	English
Vydavateľské údaje:	United States Wiley Subscription Services, Inc 01.03.2019
Predmet:	Acceptability Adolescent Adult Aged Aggression - psychology Anti-N-Methyl-D-Aspartate Receptor Encephalitis - complications Anti-N-Methyl-D-Aspartate Receptor Encephalitis - physiopathology Anti-N-Methyl-D-Aspartate Receptor Encephalitis - psychology Ataxia Ataxia - etiology Ataxia - physiopathology Autoimmune diseases Autoimmune Diseases - complications Autoimmune Diseases - physiopathology Autoimmune Diseases - psychology Autoimmune Diseases of the Nervous System - complications Autoimmune Diseases of the Nervous System - physiopathology Autoimmune Diseases of the Nervous System - psychology Brain stem Consistency Correlation analysis Correlation coefficient Correlation coefficients Delusions - psychology Dyskinesia Dyskinesias - etiology Dyskinesias - physiopathology Dystonia Dystonia - etiology Dystonia - physiopathology Encephalitis Encephalitis - complications Encephalitis - physiopathology Encephalitis - psychology Encephalomyelitis, Acute Disseminated - complications Encephalomyelitis, Acute Disseminated - physiopathology Encephalomyelitis, Acute Disseminated - psychology Female Gait Gait Disorders, Neurologic - etiology Gait Disorders, Neurologic - physiopathology Hallucinations - psychology Humans Language Disorders - etiology Language Disorders - physiopathology Limbic Encephalitis - complications Limbic Encephalitis - physiopathology Limbic Encephalitis - psychology Male Memory Disorders - etiology Memory Disorders - physiopathology Mental disorders Middle Aged Muscle Weakness - etiology Muscle Weakness - physiopathology Patients Reliability Reproducibility Reproducibility of Results Seizures - etiology Seizures - physiopathology Severity of Illness Index Signs and symptoms Stability Validity Young Adult
ISSN:	0364-5134, 1531-8249, 1531-8249
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Popis
Shrnutí:	Objective There is no scale for rating the severity of autoimmune encephalitis (AE). In this study, we aimed to develop a novel scale for rating severity in patients with diverse AE syndromes and to verify the reliability and validity of the developed scale. Methods The key items were generated by a panel of experts and selected according to content validity ratios. The developed scale was initially applied to 50 patients with AE (development cohort) to evaluate its acceptability, reproducibility, internal consistency, and construct validity. Then, the scale was applied to another independent cohort (validation cohort, n = 38). Results A new scale consisting of 9 items (seizure, memory dysfunction, psychiatric symptoms, consciousness, language problems, dyskinesia/dystonia, gait instability and ataxia, brainstem dysfunction, and weakness) was developed. Each item was assigned a value of up to 3 points. The total score could therefore range from 0 to 27. We named the scale the Clinical Assessment Scale in Autoimmune Encephalitis (CASE). The new scale showed excellent interobserver (intraclass correlation coefficient [ICC] = 0.97) and intraobserver (ICC = 0.96) reliability for total scores, was highly correlated with modified Rankin scale (r = 0.86, p < 0.001), and had acceptable internal consistency (Cronbach α = 0.88). Additionally, in the validation cohort, the scale showed high interobserver reliability (ICC = 0.99) and internal consistency (Cronbach α = 0.92). Interpretation CASE is a novel clinical scale for AE with a high level of clinimetric properties. It would be suitable for application in clinical practice and might help overcome the limitations of current outcome scales for AE. ANN NEUROL 2019;85:352–358.
Bibliografia:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 14 content type line 23
ISSN:	0364-5134 1531-8249 1531-8249
DOI:	10.1002/ana.25421