MovDisordV3, Main, Exploration, bibRecordById, Pascal:98-0353470

Treatment of cervical dystonia: A comparison of measures for outcome assessment

Identifieur interne : 004E81 ( Main/Exploration ); précédent : 004E80; suivant : 004E82

Treatment of cervical dystonia: A comparison of measures for outcome assessment

Auteurs : Robert Lindeboom [Pays-Bas] ; Jeroen W. M. Brans [Pays-Bas] ; Majid Aramideh [Pays-Bas] ; Hans D. Speelman [Pays-Bas] ; Rob J. De Haan [Pays-Bas]

Source :

Movement Disorders [ 0885-3185 ] ; 1998-07.

RBID : ISTEX:5EE55952F4B540BD41CA659AE7B55774788DB4BC

Descripteurs français

Pascal (Inist)
- Adulte, Botulisme, Cou, Douleur, Dystonie, Echelle évaluation, Effet dimensionnel, Efficacité traitement, Etude comparative, Evaluation performance, Evolution, Myorésolutif, Toxine, Traitement, Voie intramusculaire.
Wicri :
- topic : Adulte.

English descriptors

KwdEn :
- Adult, Aged, Botulinum Toxins, Type A (administration & dosage), Botulinum toxins, Botulism, Cervical dystonia, Comparative study, Disability Evaluation, Dystonia, Dystonia Musculorum Deformans (diagnosis), Dystonia Musculorum Deformans (drug therapy), Dystonia Musculorum Deformans (etiology), Evaluation scale, Evolution, Female, Humans, Injections, Intramuscular, Intramuscular administration, Male, Middle Aged, Muscle relaxant, Neck, Neurologic Examination (statistics & numerical data), Neuromuscular Agents (administration & dosage), Outcome assessment, Pain, Pain Measurement (statistics & numerical data), Performance evaluation, Quality of Life, ROC Curve, ROC curve, Size effect, Torticollis (diagnosis), Torticollis (drug therapy), Torticollis (etiology), Toxin, Treatment, Treatment Outcome, Treatment efficiency.
MESH :
- chemical , administration & dosage : Botulinum Toxins, Type A, Neuromuscular Agents.
- diagnosis : Dystonia Musculorum Deformans, Torticollis.
- drug therapy : Dystonia Musculorum Deformans, Torticollis.
- etiology : Dystonia Musculorum Deformans, Torticollis.
- statistics & numerical data : Neurologic Examination, Pain Measurement.
- Adult, Aged, Disability Evaluation, Female, Humans, Injections, Intramuscular, Male, Middle Aged, Quality of Life, ROC Curve, Treatment Outcome.

Abstract

There is little agreement on which outcome measures to use to express the efficacy of treatments for cervical dystonia. We analyzed change scores on various scales of 64 new patients with cervical dystonia before and after repeated injections with botulinum toxin. Method: The association between change in impairment (Tsui), and change in pain (TWSTRS‐Pain) and functional health (TWSTRS‐D, MOS‐20) was expressed in percentages of variance explained. Effect sizes of the outcome measures from patients who continued botulinum treatment and dropouts were compared. Performance of outcome measures to distinguish patients who continued treatment and dropouts was analyzed with ROC curves and areas under the curve (AUC). Results: Impairments explained ≤ 7% of the score variance in functional health. There were no differences between the effect sizes of impairment and pain of patients who continued treatment and dropouts (p > 0.60). This suggests a poor reflection of the treatment efficacy by these outcome measures. Conversely, there were significant differences between the effect sizes of the functional status scales of the patients who continued treatment and the dropouts (p ≤ 0.01). ROC curve analysis showed that the disability, handicap, and global disease burden scale accurately distinguished between the two groups (AUCs > 0.80). Impairments showed no discriminative accuracy (AUC = 0.46). Conclusion: Neurologic impairments have a small impact on the functional health of cervical dystonia patients. Disability, handicap, and a global measure of disease burden were the most suitable outcome parameters to express the clinical efficacy of botulinum therapy.

Url:

https://api.istex.fr/document/5EE55952F4B540BD41CA659AE7B55774788DB4BC/fulltext/pdf

DOI: 10.1002/mds.870130417

Affiliations:

Pays-Bas

Le document en format XML

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<term>Aged</term>
<term>Botulinum Toxins, Type A (administration & dosage)</term>
<term>Botulinum toxins</term>
<term>Botulism</term>
<term>Cervical dystonia</term>
<term>Comparative study</term>
<term>Disability Evaluation</term>
<term>Dystonia</term>
<term>Dystonia Musculorum Deformans (diagnosis)</term>
<term>Dystonia Musculorum Deformans (drug therapy)</term>
<term>Dystonia Musculorum Deformans (etiology)</term>
<term>Evaluation scale</term>
<term>Evolution</term>
<term>Female</term>
<term>Humans</term>
<term>Injections, Intramuscular</term>
<term>Intramuscular administration</term>
<term>Male</term>
<term>Middle Aged</term>
<term>Muscle relaxant</term>
<term>Neck</term>
<term>Neurologic Examination (statistics & numerical data)</term>
<term>Neuromuscular Agents (administration & dosage)</term>
<term>Outcome assessment</term>
<term>Pain</term>
<term>Pain Measurement (statistics & numerical data)</term>
<term>Performance evaluation</term>
<term>Quality of Life</term>
<term>ROC Curve</term>
<term>ROC curve</term>
<term>Size effect</term>
<term>Torticollis (diagnosis)</term>
<term>Torticollis (drug therapy)</term>
<term>Torticollis (etiology)</term>
<term>Toxin</term>
<term>Treatment</term>
<term>Treatment Outcome</term>
<term>Treatment efficiency</term>
</keywords>
<keywords scheme="MESH" type="chemical" qualifier="administration & dosage" xml:lang="en"><term>Botulinum Toxins, Type A</term>
<term>Neuromuscular Agents</term>
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<keywords scheme="MESH" qualifier="diagnosis" xml:lang="en"><term>Dystonia Musculorum Deformans</term>
<term>Torticollis</term>
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<keywords scheme="MESH" qualifier="drug therapy" xml:lang="en"><term>Dystonia Musculorum Deformans</term>
<term>Torticollis</term>
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<term>Torticollis</term>
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<term>Pain Measurement</term>
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<keywords scheme="MESH" xml:lang="en"><term>Adult</term>
<term>Aged</term>
<term>Disability Evaluation</term>
<term>Female</term>
<term>Humans</term>
<term>Injections, Intramuscular</term>
<term>Male</term>
<term>Middle Aged</term>
<term>Quality of Life</term>
<term>ROC Curve</term>
<term>Treatment Outcome</term>
</keywords>
<keywords scheme="Pascal" xml:lang="fr"><term>Adulte</term>
<term>Botulisme</term>
<term>Cou</term>
<term>Douleur</term>
<term>Dystonie</term>
<term>Echelle évaluation</term>
<term>Effet dimensionnel</term>
<term>Efficacité traitement</term>
<term>Etude comparative</term>
<term>Evaluation performance</term>
<term>Evolution</term>
<term>Myorésolutif</term>
<term>Toxine</term>
<term>Traitement</term>
<term>Voie intramusculaire</term>
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<front><div type="abstract" xml:lang="en">There is little agreement on which outcome measures to use to express the efficacy of treatments for cervical dystonia. We analyzed change scores on various scales of 64 new patients with cervical dystonia before and after repeated injections with botulinum toxin. Method: The association between change in impairment (Tsui), and change in pain (TWSTRS‐Pain) and functional health (TWSTRS‐D, MOS‐20) was expressed in percentages of variance explained. Effect sizes of the outcome measures from patients who continued botulinum treatment and dropouts were compared. Performance of outcome measures to distinguish patients who continued treatment and dropouts was analyzed with ROC curves and areas under the curve (AUC). Results: Impairments explained ≤ 7% of the score variance in functional health. There were no differences between the effect sizes of impairment and pain of patients who continued treatment and dropouts (p > 0.60). This suggests a poor reflection of the treatment efficacy by these outcome measures. Conversely, there were significant differences between the effect sizes of the functional status scales of the patients who continued treatment and the dropouts (p ≤ 0.01). ROC curve analysis showed that the disability, handicap, and global disease burden scale accurately distinguished between the two groups (AUCs > 0.80). Impairments showed no discriminative accuracy (AUC = 0.46). Conclusion: Neurologic impairments have a small impact on the functional health of cervical dystonia patients. Disability, handicap, and a global measure of disease burden were the most suitable outcome parameters to express the clinical efficacy of botulinum therapy.</div>
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Movement Disorders (revue)

Treatment of cervical dystonia: A comparison of measures for outcome assessment

Treatment of cervical dystonia: A comparison of measures for outcome assessment

Source :

Descripteurs français

English descriptors

Abstract

Links toward previous steps (curation, corpus...)

Le document en format XML

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	Movement Disorders (revue)
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