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Telephone consultation for myasthenia gravis care during the COVID ‐19 pandemic: Assessment of a novel virtual myasthenia gravis index
Author(s) -
Me Deepak,
Alnajjar Sara,
Barnett Carolina,
Vijayan Joy,
Katzberg Hans,
Fathi Davood,
Alcantara Monica,
Bril Vera
Publication year - 2021
Publication title -
muscle and nerve
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.025
H-Index - 145
eISSN - 1097-4598
pISSN - 0148-639X
DOI - 10.1002/mus.27243
Subject(s) - myasthenia gravis , covid-19 , pandemic , medicine , index (typography) , virology , immunology , disease , computer science , world wide web , outbreak , infectious disease (medical specialty)
/Aims The aim of the study was to determine the association between the virtual Myasthenia Gravis Impairment Index (vMGII) with other patient‐reported outcomes (PROs) of myasthenia gravis (MG) and its usefulness in telephone consultations with MG patients. Methods This was a retrospective case series in which vMGII score along with virtual Single Simple Question (vSSQ), virtual Patient‐Acceptable Symptom State PASS (vPASS) response, and patient disease status based on Myathenia Gravis Foundation of America postintervention status were collected during telephone consultation along with the MGII, SSQ, and PASS responses during the preceding in‐person clinic visits. Results In 214 patients, the mean difference of vMGII between the vPASS “Yes” and “No” groups was −14.2 ± 1.4 (95% confidence interval, −16.9 to −11.3; P < .001) with mean vMGII for vPASS “Yes” group being 6.4 ± 7.7 and vPASS “No” being 20.5 ± 11.5. A vMGII of 11.5 or higher predicted vPASS “yes” response with a sensitivity of 78.7% and specificity of 81.4%. A strong negative correlation was found between the vMGII and vSSQ (r = −.667; P < .001). The mean vMGII was 0.48 ± 1.42 for patients in remission, and 9.31 ± 10.93 for improved, 9.32 ± 8.79 for stable, and 22.58 ± 14.04 for worsened groups ( P < .001). These associations were the same as those obtained during the preceding in‐person clinic visit and the direction of change in MGII scores also indicated change in disease status. Discussion vMGII is an effective measure to assess an MG patient's disease status in telephone consultations and relates well with other PRO measures. The vMGII remains reliable for assessing MG disease status even with removal of the physical examination component.