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Development of the clinical assessment scale in autoimmune encephalitis.
- Source :
-
Annals of neurology [Ann Neurol] 2019 Mar; Vol. 85 (3), pp. 352-358. Date of Electronic Publication: 2019 Feb 10. - Publication Year :
- 2019
-
Abstract
- 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.<br />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).<br />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).<br />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.<br /> (© 2019 American Neurological Association.)
- Subjects :
- 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 etiology
Ataxia physiopathology
Autoimmune Diseases complications
Autoimmune Diseases physiopathology
Autoimmune Diseases psychology
Autoimmune Diseases of the Nervous System complications
Delusions psychology
Dyskinesias etiology
Dyskinesias physiopathology
Dystonia etiology
Dystonia physiopathology
Encephalitis complications
Encephalomyelitis, Acute Disseminated complications
Encephalomyelitis, Acute Disseminated physiopathology
Encephalomyelitis, Acute Disseminated psychology
Female
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
Middle Aged
Muscle Weakness etiology
Muscle Weakness physiopathology
Reproducibility of Results
Seizures etiology
Seizures physiopathology
Severity of Illness Index
Young Adult
Autoimmune Diseases of the Nervous System physiopathology
Autoimmune Diseases of the Nervous System psychology
Encephalitis physiopathology
Encephalitis psychology
Subjects
Details
- Language :
- English
- ISSN :
- 1531-8249
- Volume :
- 85
- Issue :
- 3
- Database :
- MEDLINE
- Journal :
- Annals of neurology
- Publication Type :
- Academic Journal
- Accession number :
- 30675918
- Full Text :
- https://doi.org/10.1002/ana.25421