The utility of Guillain‐Barré syndrome prognostic models in Malaysian patients

Tan, Cheng‐Yin; Razali, Siti Nur Omaira; Goh, Kim‐Leng; Shahrizaila, Nortina

doi:10.1111/jns.12320

Cited by 25 publications

(41 citation statements)

References 27 publications

(53 reference statements)

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“…The study by Tan et al also provided an AUC value for the group of severely affected (GBS disability score ≥ 3) GBS patients (without MFS), which was similar to the AUC value in our Asian cohort (0.786). 19,20 Model calibration was not described in these studies but could be deduced from the reported results. In both studies, the risk of mechanical ventilation was underestimated by the EGRIS model (Yamagishi et al: predicted probability 13%, observed 17%; Tan et al: predicted probability 23%, observed 44%).…”

Section: Discussionmentioning

confidence: 99%

“…Our findings are in line with previous studies that validated the EGRIS in Japan and Malaysia. 19 , 20 Both studies assessed the discriminative ability of the model by comparing EGRIS scores between patients who did and did not require mechanical ventilation within the first week of admission. EGRIS scores were significantly higher for patients who required mechanical ventilation.…”

Section: Discussionmentioning

confidence: 99%

“… 5 Until now, validation has only been performed in 2 smaller Asian cohorts. 19 , 20 Therefore, this study aimed to validate the EGRIS in the IGOS cohort to define its performance in an international GBS population. The second aim was to further improve model performance by applying region‐specific adjustments to the EGRIS.…”

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confidence: 99%

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International Validation of the Erasmus Guillain–Barré Syndrome Respiratory Insufficiency Score

Doets

Walgaard

Lingsma

et al. 2022

Annals of Neurology

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This study aimed to validate the Erasmus Guillain-Barré Syndrome Respiratory Insufficiency Score in the International Guillain-Barré Syndrome Outcome Study cohort, and to improve its performance and region-specificity. Methods: We examined data from the first 1,500 included patients, aged ≥6 years and not ventilated prior to study entry. Patients with a clinical variant or mild symptoms were also included. Outcome was mechanical ventilation within the first week from study entry. Model performance was assessed regarding the discriminative ability (area under the receiver operating characteristic curve) and the calibration (observed vs predicted probability of mechanical ventilation), in the full cohort and in Europe/North America and Asia separately. We recalibrated the model to improve its performance and region-specificity. Results: In the group of 1,023 eligible patients (Europe/North America n = 842, Asia n = 104, other n = 77), 104 (10%) required mechanical ventilation within the first week from study entry. Area under the curve values were ≥0.80 for all validation subgroups. Mean observed proportions of mechanical ventilation were lower than predicted risks: full cohort 10% versus 21%, Europe/North America 9% versus 21%, and Asia 17% versus 23%. After recalibration, predicted risks for the full cohort and Europe/North America corresponded to observed proportions. Interpretation: This prospective, international cohort study validated the Erasmus Guillain-Barré Syndrome Respiratory Insufficiency Score, and showed that the model can be used in the full spectrum of Guillain-Barré syndrome patients. In addition, a more accurate, region-specific version of the model was developed for patients from Europe/North America.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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International Validation of the Erasmus Guillain–Barré Syndrome Respiratory Insufficiency Score

Doets

Walgaard

Lingsma

et al. 2022

Annals of Neurology

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“…Несмотря на то что mEGOS, как и ее предыдущая версия, в ряде исследований показали высокую достоверность [19,[28][29][30][31], являясь простым, не требующим дополнительных затрат, методом прогнозирования возможности восстановления ходьбы к 6 мес после СГБ на этапе острого периода, данные шкалы несовершенны, что и показали представленные в статье клинические случаи. У обеих пациенток прогноз восстановления в остром периоде, в том числе с использованием шкал EGOS и mEGOS, оказался ошибочным.…”

Section: Introductionunclassified

“…Низкую прогностическую значимость шкал EGOS и mEGOS отметили и другие исследователи [28,35]. Наиболее вероятной причиной подобного несоответствия, на наш взгляд, является отсутствие учета в шкалах нейрофизиологических данных и формы заболевания.…”

Section: Introductionunclassified

Specificity of recovery in acute motor axonal neuropathy with conduction blocks on the example of two clinical cases

Grishina¹,

Супонева²

2020

Neuromuscular Diseases

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Introduction. The heterogeneity of the forms and severity of Guillain-Barre syndrome explains the variability of recovery: from rapid and complete (in most cases) to slow with the development of persistent residual deficiency (rarely). It is unclear how effective the Erasmus Guillain–Barre syndrome Outcome Scores and its modified version are for different forms of the disease.The aim of the study – to demonstrate the features of recovery in acute motor axonal neuropathy with conduction blocks on the example of 2 clinical cases; to show the possibilities of Erasmus Guillain–Barre syndrome Outcome Scores and its modified version in predicting recovery in this form of the disease.Materials and methods. Data from 2 patients with acute motor axonal neuropathy with motor conduction blocks were retrospectively analyzed. Calculation of the score and assessment of the prognosis of walking recovery by 6 months from the onset of the disease were performed using the online calculator International Guillain-Barre syndrome Outcome Study Prognosis tool in the acute period.Results. In both patients, the forecast of recovery of walking by half a year from the onset of the disease on the Erasmus Guillain–Barre syndrome Outcome Scores and modified Erasmus Guillain–Barre syndrome Outcome Scores scales in the acute period was erroneous. In the first case, the total score on the Erasmus Guillain–Barre syndrome Outcome Scores and its modification in the acute period was 5 and 10 points respectively (poor prognosis), which foreshadowed a long rehabilitation process and incomplete recovery. However, the regression of disorders was dramatic and complete, and by the second month of the disease, only minimal motor disorders remained. In the second patient, on the contrary, the total Erasmus Guillain–Barre syndrome Outcome Scores and its modification during the period of increasing symptoms was 3 and 7 points respectively (good prognosis), while recovery was delayed – only by 5 months from the onset of the disease, the ability to move with support was restored.Conclusion. The Guillain–Barre syndrome is a disease with a favorable prognosis for recovery. However, the prediction of regression of motor disorders should be approached carefully, because in some cases, generally accepted criteria and prognostic scales may not work. Acute motor axonal neuropathy with conduction blocks is a unique form of the disease that has pathophysiological and clinical-neurophysiological features, which should be taken into account when managing this category of patients.

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Validation and adjustment of modified Erasmus GBS outcome score in Bangladesh

Papri

Doets

Mohammad

et al. 2022

Ann Clin Transl Neurol

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Objective We have assessed and improved the performance of the modified Erasmus GBS Outcome Score (mEGOS) among patients with Guillain‐Barré syndrome (GBS) from Bangladesh. Methods Validation cohort consisted of patients with GBS from two prospective cohort studies in Bangladesh. Poor outcome was defined as being unable to walk independently at week 4 and week 26. We excluded patients able to walk independently, patients who died within the first week, or with missing GBS disability scores. Performance of mEGOS at entry and week 1 was determined based on the discriminative ability (ability to differentiate between patients able and unable to walk independently; measured using the area under the receiver operating characteristic curves [AUC]) and calibration (observed probability versus predicted probability of poor outcome). Results A total of 506 patients aged ≥6‐year‐old were enrolled, with 471 and 366 patients included in mEGOS validation analysis at entry and week 1, respectively. The AUC values for predicting poor outcome (1) at week 4 were 0.69 (mEGOS entry) and 0.78 (mEGOS week 1) and (2) at week 26 were 0.67 (mEGOS entry) and 0.70 (mEGOS week 1). Mean predicted probabilities of poor outcome corresponded with observed outcomes except for the probability of poor outcome at week 4 which was overestimated by mEGOS week 1. This was resolved by updating the model intercept. Interpretation The mEGOS shows valid outcome predictions among patients with GBS from Bangladesh. The model can aid the identification of patients at high risk of poor outcome and help to adequately allocate healthcare resources in low‐resource settings.

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The utility of Guillain‐Barré syndrome prognostic models in Malaysian patients

Cited by 25 publications

References 27 publications

International Validation of the Erasmus Guillain–Barré Syndrome Respiratory Insufficiency Score

International Validation of the Erasmus Guillain–Barré Syndrome Respiratory Insufficiency Score

Specificity of recovery in acute motor axonal neuropathy with conduction blocks on the example of two clinical cases

Validation and adjustment of modified Erasmus GBS outcome score in Bangladesh

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