Doets, Alex Y., Lingsma, Hester F., Walgaard, Christa, Islam, Badrul, Papri, Nowshin, Davidson, Amy, Kusunoki, Susumu, Dimachkie, Mazen M., Waheed, Waqar, Kolb, Noah, Islam, Zhahirul, Mohammad, Quazi Deen, Harbo, Thomas, Sindrup, Soren H., Chavada, Govindsinh, Willison, Hugh J., Casasnovas, Carlos, Bateman, Kathleen, Miller, James A. L., van den Berg, Bianca, Verboon, Christine, Roodbol, Joyce, Leonhard, Sonja E., Benedetti, Luana, Kuwabara, Satoshi, Van den Bergh, Peter, Monges, Soledad, Marfia, Girolama A., Shahrizaila, Nortina, Galassi, Giuliana, Pereon, Yann, Burmann, Jan, Kuitwaard, Krista, Kleyweg, Ruud P., Marchesoni, Cintia, Tous, Maria J. Sedano, Querol, Luis, Illa, Isabel, Wang, Yuzhong, Nobile-Orazio, Eduardo, Rinaldi, Simon, Schenone, Angelo, Pardo, Julio, Vermeij, Frederique H., Lehmann, Helmar C., Granit, Volkan, Cavaletti, Guido, Gutierrez-Gutierrez, Gerardo ORCID: 0000-0003-1391-754X, Barroso, Fabio A., Visser, Leo H., Katzberg, Hans D., Dardiotis, Efthimios, Attarian, Shahram, van der Kooi, Anneke J., Eftimov, Filip ORCID: 0000-0002-0146-0776, Wirtz, Paul W., Samijn, Johnny P. A., Gilhuis, H. Jacobus, Hadden, Robert D. M., Holt, James K. L., Sheikh, Kazim A., Karafiath, Summer, Vytopil, Michal, Antonini, Giovanni, Feasby, Thomas E., Faber, Catharina G., Gijsbers, Cees J., Busby, Mark, Roberts, Rhys C., Silvestri, Nicholas J., Fazio, Raffaella, van Dijk, Gert W., Garssen, Marcel P. J., Straathof, Chiara S. M., Gorson, Kenneth C. and Jacobs, Bart C. (2022). Predicting Outcome in Guillain-Barre Syndrome International Validation of the Modified Erasmus GBS Outcome Score. Neurology, 98 (5). S. E518 - 15. PHILADELPHIA: LIPPINCOTT WILLIAMS & WILKINS. ISSN 1526-632X

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Abstract

Background and Objectives 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: Journal Article
Creators:
CreatorsEmailORCIDORCID Put Code
Doets, Alex Y.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Lingsma, Hester F.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Walgaard, ChristaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Islam, BadrulUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Papri, NowshinUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Davidson, AmyUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Kusunoki, SusumuUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Dimachkie, Mazen M.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Waheed, WaqarUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Kolb, NoahUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Islam, ZhahirulUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Mohammad, Quazi DeenUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Harbo, ThomasUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Sindrup, Soren H.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Chavada, GovindsinhUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Willison, Hugh J.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Casasnovas, CarlosUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Bateman, KathleenUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Miller, James A. L.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
van den Berg, BiancaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Verboon, ChristineUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Roodbol, JoyceUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Leonhard, Sonja E.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Benedetti, LuanaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Kuwabara, SatoshiUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Van den Bergh, PeterUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Monges, SoledadUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Marfia, Girolama A.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Shahrizaila, NortinaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Galassi, GiulianaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Pereon, YannUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Burmann, JanUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Kuitwaard, KristaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Kleyweg, Ruud P.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Marchesoni, CintiaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Tous, Maria J. SedanoUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Querol, LuisUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Illa, IsabelUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Wang, YuzhongUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Nobile-Orazio, EduardoUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Rinaldi, SimonUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Schenone, AngeloUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Pardo, JulioUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Vermeij, Frederique H.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Lehmann, Helmar C.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Granit, VolkanUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Cavaletti, GuidoUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Gutierrez-Gutierrez, GerardoUNSPECIFIEDorcid.org/0000-0003-1391-754XUNSPECIFIED
Barroso, Fabio A.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Visser, Leo H.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Katzberg, Hans D.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Dardiotis, EfthimiosUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Attarian, ShahramUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
van der Kooi, Anneke J.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Eftimov, FilipUNSPECIFIEDorcid.org/0000-0002-0146-0776UNSPECIFIED
Wirtz, Paul W.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Samijn, Johnny P. A.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Gilhuis, H. JacobusUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Hadden, Robert D. M.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Holt, James K. L.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Sheikh, Kazim A.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Karafiath, SummerUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Vytopil, MichalUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Antonini, GiovanniUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Feasby, Thomas E.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Faber, Catharina G.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Gijsbers, Cees J.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Busby, MarkUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Roberts, Rhys C.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Silvestri, Nicholas J.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Fazio, RaffaellaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
van Dijk, Gert W.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Garssen, Marcel P. J.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Straathof, Chiara S. M.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Gorson, Kenneth C.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Jacobs, Bart C.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
URN: urn:nbn:de:hbz:38-699426
DOI: 10.1212/WNL.0000000000013139
Journal or Publication Title: Neurology
Volume: 98
Number: 5
Page Range: S. E518 - 15
Date: 2022
Publisher: LIPPINCOTT WILLIAMS & WILKINS
Place of Publication: PHILADELPHIA
ISSN: 1526-632X
Language: English
Faculty: Unspecified
Divisions: Unspecified
Subjects: no entry
Uncontrolled Keywords:
KeywordsLanguage
INTRAVENOUS IMMUNOGLOBULIN; POOR-PROGNOSIS; MODELSMultiple languages
Clinical NeurologyMultiple languages
URI: http://kups.ub.uni-koeln.de/id/eprint/69942

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