Rasch Analysis of Muscle Strength in Neuromuscular Disorders
The MRC data of each muscle group were treated as if it was an ‘item’ that needed to be completed by the patients with response options from 0 to 5 (in the current study setting: a physician completed the ‘item’) using the Rasch Unidimensional Measurement Model 2020 software (Andrich et al., 2003 ). In Analysis 1 (MRC Rasch in each cohort separately), the following person factors were taken into account (Supplementary Table 2):
Ages: 1, <40 years; 2, 40–59 years and 3, ≥60 years;
gender: 0, female; 1, male;
type of disease: (a) inflammatory neuropathy-cause-and-treatment cohort: 1, Guillain–Barré syndrome; 2, CIDP; 3, gammopathy related polyneuropathy; (b) myotonic dystrophy cohort: 1, mild; 2, adult; 3, child/congenital type; and (c) limb-girdle dystrophy cohort: 1, sarcoglycanopathy; 2, calpainopathy; 3, limb-girdle type 1B, 2B and 2I; 4, unclassified;
duration of disease: (a) for all cohorts except limb-girdle patients: 1, <5 years; 2, 5–9 years; 3, 10–19 years; 4, ≥20 years; and (b) for limb-girdle cohort: 1, <10 years; 2, 10–19 years; 3, 20–29 years; 4, ≥30 years;
physician's experience in the neuromuscular field: for the inflammatory–neuropathy cause and treatment studies: 1, <3 years experience; 2, 3–5 years experience; 3, ≥6 years experience; the latter group constituting senior neuromuscular experts;
institution; for the Guillain–Barré syndrome trials: 0, community based; 1, university based hospital; and
country; for the Guillain–Barré syndrome cohort 2004: 1, The Netherlands; 2, Germany; 3, Belgium.
For Analyses 2 and 3 (MRC Rasch after pooling data and MRC sum score in Guillain–Barré syndrome/CIDP), the factors studied included (i) age category: 1, <40 years; 2, 40–59 years; 3, ≥60 years; (ii) gender: 0, female; 1, male; and (iii) type of disease: depending on the amount of illnesses being pooled together, each illness received a separate code. For the MRC sum score analysis, the person separation index was also determined, which should be ≥0.7 for proper group comparison, and a minimum of 0.9 for clinical use (Bland and Altman, 1997 (link)). The unrestricted partial credit Rasch model was used. Further analyses were undertaken using Stata 11.0 statistical software for Windows XP.
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Vanhoutte E.K., Faber C.G., van Nes S.I., Jacobs B.C., van Doorn P.A., van Koningsveld R., Cornblath D.R., van der Kooi A.J., Cats E.A., van den Berg L.H., Notermans N.C., van der Pol W.L., Hermans M.C., van der Beek N.A., Gorson K.C., Eurelings M., Engelsman J., Boot H., Meijer R.J., Lauria G., Tennant A, & Merkies I.S. (2011). Modifying the Medical Research Council grading system through Rasch analyses. Brain, 135(5), 1639-1649.
Other organizations :
Maastricht University Medical Centre, Erasmus University Rotterdam, Elkerliek Ziekenhuis, Johns Hopkins Hospital, Johns Hopkins University, Academic Medical Center, University Medical Center Utrecht, St. Elizabeth's Medical Center, Tufts University, Spaarne Ziekenhuis, University of Leeds
Ages: 1, <40 years; 2, 40–59 years and 3, ≥60 years
Gender: 0, female; 1, male
Type of disease: (a) inflammatory neuropathy-cause-and-treatment cohort: 1, Guillain–Barré syndrome; 2, CIDP; 3, gammopathy related polyneuropathy; (b) myotonic dystrophy cohort: 1, mild; 2, adult; 3, child/congenital type; and (c) limb-girdle dystrophy cohort: 1, sarcoglycanopathy; 2, calpainopathy; 3, limb-girdle type 1B, 2B and 2I; 4, unclassified
Duration of disease: (a) for all cohorts except limb-girdle patients: 1, <5 years; 2, 5–9 years; 3, 10–19 years; 4, ≥20 years; and (b) for limb-girdle cohort: 1, <10 years; 2, 10–19 years; 3, 20–29 years; 4, ≥30 years
Physician's experience in the neuromuscular field: for the inflammatory–neuropathy cause and treatment studies: 1, <3 years experience; 2, 3–5 years experience; 3, ≥6 years experience
Institution; for the Guillain–Barré syndrome trials: 0, community based; 1, university based hospital
Country; for the Guillain–Barré syndrome cohort 2004: 1, The Netherlands; 2, Germany; 3, Belgium
dependent variables
MRC data of each muscle group
control variables
Physician completed the 'item' using the Rasch Unidimensional Measurement Model 2020 software
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