{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,18]],"date-time":"2026-06-18T04:18:22Z","timestamp":1781756302059,"version":"3.54.5"},"reference-count":25,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2022,1,10]],"date-time":"2022-01-10T00:00:00Z","timestamp":1641772800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100013560","name":"GBS\/CIDP Foundation International","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100013560","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100008721","name":"University College London Hospitals NHS Foundation Trust","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100008721","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Peripheral Nervous Sys"],"published-print":{"date-parts":[[2022,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Immunoglobulin (Ig) is used to treat chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) and multifocal motor neuropathy with conduction block (MMNCB). Regular infusions may be used for symptom control. Disease activity is monitored with clinical outcome measurements. We examined outcome measure variation during clinically stable periods in Ig\u2010treated CIDP and MMNCB patients. We explored utility of serial outcome measurement in long\u2010term outcome prediction. Retrospective longitudinal analysis of a single neuroscience centre's Ig\u2010treated CIDP and MMNCB patients, 2009\u20102020, was performed. Mean and percentage change for grip strength, Rasch\u2010built overall disability scales (RODS) and MRC sum scores (MRC\u2010SS) during periods of clinical stability were compared to score\u2010specific minimal clinically important differences (MCID). Latent class mixed modelling (LCMM) was used to identify longitudinal trends and factors influencing long\u2010term outcome. We identified 85 CIDP and 23\u2009MMNCB patients (1423 datapoints; 5635 treatment\u2010months). Group\u2010averaged outcome measures varied little over time. Intra\u2010individual variation exceeded MCID for RODS in 44.2% CIDP and 16.7% MMNCB datapoints, grip strength in 10.6% (CIDP) and 8.8%\/27.2% (MMNCB right\/left hand) and MRC\u2010SS in 43.5% (CIDP) and 20% (MMNCB). Multivariate LCMM identified subclinical trends towards improvement (32 patients) and deterioration (73 patients) in both cohorts. At baseline, CIDP \u2018deteriorators\u2019 were older than \u2018improvers\u2019 (66.2 vs 57\u2009years, <jats:italic>P<\/jats:italic>\u00a0=\u2009.025). No other individual factors predicted categorisation. The best model for \u2018deteriorator\u2019 identification was contiguous sub\u2010MCID decline in more than one outcome measure (CIDP: sensitivity 74%, specificity 59%; MMNCB: sensitivity 73%, specificity 88%). Outcome measure interpretation determines therapeutic decision\u2010making in Ig\u2010dependent neuropathy patients, but intra\u2010individual variation is common, often exceeding MCID. Here we show sub\u2010MCID contiguous changes in more than one outcome measurement are a better predictor of long\u2010term outcome.<\/jats:p>","DOI":"10.1111\/jns.12481","type":"journal-article","created":{"date-parts":[[2021,12,22]],"date-time":"2021-12-22T12:33:55Z","timestamp":1640176435000},"page":"84-93","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Predicting long\u2010term trends in inflammatory neuropathy outcome measures using latent class modelling"],"prefix":"10.1111","volume":"27","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6434-9496","authenticated-orcid":false,"given":"Ryan Yann Shern","family":"Keh","sequence":"first","affiliation":[{"name":"Manchester Centre for Clinical Neurosciences Salford Royal Hospital, Northern Care Alliance NHS Foundation Trust  Manchester UK"},{"name":"MRC Centre for Neuromuscular Diseases, National Hospital of Neurology and Neurosurgery, Queen Square University College London Hospitals NHS Foundation Trust  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David Antony","family":"Selby","sequence":"additional","affiliation":[{"name":"Division of Musculoskeletal and Dermatological Sciences University of Manchester  Manchester UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sam","family":"Jones","sequence":"additional","affiliation":[{"name":"Manchester Centre for Clinical Neurosciences Salford Royal Hospital, Northern Care Alliance NHS Foundation Trust  Manchester UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Gosal","sequence":"additional","affiliation":[{"name":"Manchester Centre for Clinical Neurosciences Salford Royal Hospital, Northern Care Alliance NHS Foundation Trust  Manchester UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Timothy","family":"Lavin","sequence":"additional","affiliation":[{"name":"Manchester Centre for Clinical Neurosciences Salford Royal Hospital, Northern Care Alliance NHS Foundation Trust  Manchester UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James B.","family":"Lilleker","sequence":"additional","affiliation":[{"name":"Manchester Centre for Clinical Neurosciences Salford Royal Hospital, Northern Care Alliance NHS Foundation Trust  Manchester UK"},{"name":"Division of Musculoskeletal and Dermatological Sciences University of Manchester  Manchester UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aisling S.","family":"Carr","sequence":"additional","affiliation":[{"name":"MRC Centre for Neuromuscular Diseases, National Hospital of Neurology and Neurosurgery, Queen Square University College London Hospitals NHS Foundation Trust  London UK"},{"name":"Institute of Neurology University College London  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3174-6027","authenticated-orcid":false,"given":"Michael P.","family":"Lunn","sequence":"additional","affiliation":[{"name":"MRC Centre for Neuromuscular Diseases, National Hospital of Neurology and Neurosurgery, Queen Square University College London Hospitals NHS Foundation Trust  London UK"},{"name":"Institute of Neurology University College London  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2022,1,10]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/ene.14959"},{"issue":"4","key":"e_1_2_9_3_1","doi-asserted-by":"crossref","first-page":"295","DOI":"10.1111\/j.1529-8027.2010.00290.x","article-title":"European Federation of Neurological Societies\/Peripheral Nerve Society guideline on management of multifocal motor neuropathy: report of a joint task force of the European Federation of Neurological Sciences and the Peripheral Nerve Society \u2013 first revision","volume":"15","author":"Joint Task Force of the EFNS and the PNS","year":"2020","journal-title":"J Peripher Nerv Syst"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(17)30378-2"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00415-020-10318-3"},{"key":"e_1_2_9_6_1","unstructured":"NHS England. Updated Commissioning Guidance for the use of therapeutic immunoglobulin (Ig) in immunology haematology neurology and infectious diseases in England December 2018. V1.0. 2018.https:\/\/www.england.nhs.uk\/wp-content\/uploads\/2019\/03\/PSS9-Immunoglobulin-Commissioning-Guidance-CQUIN-1920.pdf. 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