{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T18:49:12Z","timestamp":1788461352360,"version":"build-2803163510"},"reference-count":15,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2025,6,25]],"date-time":"2025-06-25T00:00:00Z","timestamp":1750809600000},"content-version":"vor","delay-in-days":24,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100003196","name":"Ministero della Salute","doi-asserted-by":"publisher","award":["GR\u20102021\u201012375527"],"award-info":[{"award-number":["GR\u20102021\u201012375527"]}],"id":[{"id":"10.13039\/501100003196","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Euro J of Neurology"],"published-print":{"date-parts":[[2025,6]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Patient Acceptable Symptom State (PASS) is emerging as a valuable subjective measure of the overall myasthenia gravis (MG)\u2010related burden. This study aimed at identifying PASS\u2010positive thresholds for the most used clinical scales, investigating whether PASS and MGFA post\u2010intervention status capture different aspects of the disease outcome, and identifying clinical variables associated with PASS=YES response.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Adult AChR\u2010MG patients were prospectively enrolled at two Italian Centres (Rome: index cohort; Florence: validation cohort). PASS thresholds for MG\u2010ADL, QMG, and MG\u2010QOL15r were defined in the index cohort by ROC analysis and validated in the validation cohort; predictors of favorable PASS were identified by multivariable analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      This study included 173 patients (44% females, median age at onset: 53\u2009years). PASS=YES patients had significantly lower median MG\u2010ADL, QMG, and MG\u2010QOL15r scores, with the following thresholds for PASS=YES: MG ADL \u2264\u20092, QMG \u2264\u20098 and MG\u2010QOL15r \u2264\u20096. The MG\u2010ADL (OR\u2009=\u20090.46, 95% CI\u2009=\u20090.36\u20130.60,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001), QMG (OR\u2009=\u20090.72, 95% CI\u2009=\u20090.64\u20130.81,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001) and MG\u2010QOL15r (OR\u2009=\u20090.76, 95% CI\u2009=\u20090.70\u20130.84,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001), were independently associated with a favorable PASS. The degree of ocular involvement in each scale was the strongest negative determinant of PASS=YES.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This study validates the PASS question and highlights the relevance of ocular complaints in patients' perception of MG burden.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/ene.70262","type":"journal-article","created":{"date-parts":[[2025,6,25]],"date-time":"2025-06-25T03:14:58Z","timestamp":1750821298000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Validation of the \u201cPatient\u2010Acceptable Symptom State\u201d Question as Outcome Measure in\n                    <scp>AChR<\/scp>\n                    Myasthenia Gravis: A Multicentre, Prospective Study"],"prefix":"10.1111","volume":"32","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0656-9671","authenticated-orcid":false,"given":"Gregorio","family":"Spagni","sequence":"first","affiliation":[{"name":"Department of Neurosciences, Psychology, Drug Research and Child Health (NEUROFARBA) University of Florence  Florence Italy"},{"name":"Department of Neurosciences and Sensory Organs Careggi University Hospital  Florence Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Massimiliano Ugo","family":"Verza","sequence":"additional","affiliation":[{"name":"Department of Neurosciences, Psychology, Drug Research and Child Health (NEUROFARBA) University of Florence  Florence Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sara","family":"Cornacchini","sequence":"additional","affiliation":[{"name":"Department of Neurosciences, Psychology, Drug Research and Child Health (NEUROFARBA) University of Florence  Florence Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesca","family":"Beretta","sequence":"additional","affiliation":[{"name":"Department of Neurosciences, Psychology, Drug Research and Child Health (NEUROFARBA) University of Florence  Florence Italy"},{"name":"Department of Neurosciences and Sensory Organs Careggi University Hospital  Florence Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bo","family":"Sun","sequence":"additional","affiliation":[{"name":"Nuffield Department of Clinical Neurosciences University of Oxford  Oxford UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonio","family":"Lotti","sequence":"additional","affiliation":[{"name":"Department of Neurosciences, Psychology, Drug Research and Child Health (NEUROFARBA) University of Florence  Florence Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Silvia","family":"Falso","sequence":"additional","affiliation":[{"name":"Department of Neurosciences Catholic University of the Sacred Hearth  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alessandro","family":"Barilaro","sequence":"additional","affiliation":[{"name":"Department of Neurosciences and Sensory Organs Careggi University Hospital  Florence Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luca","family":"Massacesi","sequence":"additional","affiliation":[{"name":"Department of Neurosciences, Psychology, Drug Research and Child Health (NEUROFARBA) University of Florence  Florence Italy"},{"name":"Department of Neurosciences and Sensory Organs Careggi University Hospital  Florence Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4644-2299","authenticated-orcid":false,"given":"Amelia","family":"Evoli","sequence":"additional","affiliation":[{"name":"Department of Neurosciences Catholic University of the Sacred Hearth  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Valentina","family":"Damato","sequence":"additional","affiliation":[{"name":"Department of Neurosciences, Psychology, Drug Research and Child Health (NEUROFARBA) University of Florence  Florence Italy"},{"name":"Department of Neurosciences and Sensory Organs Careggi University Hospital  Florence Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,6,25]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41582-023-00916-w"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1080\/14737175.2023.2207739"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1080\/1744666X.2021.1936500"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000012604"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000010574"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/ene.14397"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.3389\/fneur.2023.1187189"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10072-019-03746-1"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1749-6632.1998.tb11015.x"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.52.7.1487"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1002\/mus.25198"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2024.1502721"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(23)00080-7"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(23)00077-7"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1002\/mus.23398"}],"container-title":["European Journal of Neurology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/ene.70262","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,6,26]],"date-time":"2025-06-26T09:48:50Z","timestamp":1750931330000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/ene.70262"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,6]]},"references-count":15,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2025,6]]}},"alternative-id":["10.1111\/ene.70262"],"URL":"https:\/\/doi.org\/10.1111\/ene.70262","archive":["Portico"],"relation":{},"ISSN":["1351-5101","1468-1331"],"issn-type":[{"value":"1351-5101","type":"print"},{"value":"1468-1331","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,6]]},"assertion":[{"value":"2025-01-25","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-06-12","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-06-25","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70262"}}