Journal article
Development and validation of the Charcot-Marie-Tooth Disease Infant Scale
Brain (London, England : 1878), Vol.141(12), pp.3319-3330
12/01/2018
DOI: 10.1093/brain/awy280
PMCID: PMC6312041
PMID: 30476010
Abstract
Many genetic subtypes of Charcot-Marie-Tooth disease (CMT) show signs of symptomatic disease during the earliest years of life. This might be the ideal time to intervene before progression of clinical sequelae due to demyelination and axonal loss. In the absence of disease-specific clinical trial outcome measures for CMT during infancy and early childhood the aim of this study was to develop and validate a functional measure of disease severity, known as the Charcot-Marie-Tooth disease Infant Scale (CMTInfS). Development projects involved identification of a preliminary pool of 31 items representing the range of disability in affected patients aged 0-4 years from a systematic review of the literature, peer review by 12 expert clinicians and researchers in the field, design of a scoring algorithm and pilot testing in 22 participants. Subsequently, a series of validation projects were conducted based on 128 assessments of: 26 confirmed cases of inherited neuropathy (17 CMT1A, one CMT1B, one CMT1D, one CMT2C, one CMT2S, two CMT4C, one CMTX3, one Riboflavin Transporter Deficiency Type 2, and one unidentified mutation); seven 'at risk' cases and 95 unaffected healthy controls recruited through the NIH-funded Inherited Neuropathies Consortium. Validation projects included: Item, Factor and Rasch analysis, intra- and inter-rater reliability, discriminant ability and convergent validity with the CMT Pediatric Scale (CMTPedS) for children aged 3-4 years. Development and validation projects produced a psychometrically robust 15-item scale. Rasch analysis supported the viability of the CMTInfS as a unidimensional measure of disease severity and showed good overall model fit, no evidence of misfitting items or persons and was well targeted for affected children. The CMTInfS demonstrated high intra-rater reliability [intraclass correlation coefficient (ICC)3,1 0.999, 95% confidence interval 0.996-1.000) and inter-rater reliability (ICC2,1 0.997, 95% confidence interval 0.992-0.999). The CMTInfS was able to discriminate between the CMT group and controls (P = 0.006), and convergent validity demonstrated good agreement between CMTInfS and CMTPedS scores (r = 0.76, P = 0.01). The final version of the CMTInfS requires 20 min to administer and is a reliable and sensitive functional outcome measure for early onset CMT and related neuropathies.10.1093/brain/awy280_video1awy280media15970672819001.
Details
- Title: Subtitle
- Development and validation of the Charcot-Marie-Tooth Disease Infant Scale
- Creators
- Melissa R Mandarakas - Sydney Children's Hospitals Network (Randwick and Westmead), Sydney, New South Wales, AustraliaManoj P Menezes - Sydney Children's Hospitals Network (Randwick and Westmead), Sydney, New South Wales, AustraliaKristy J Rose - Sydney Children's Hospitals Network (Randwick and Westmead), Sydney, New South Wales, AustraliaRosemary Shy - University of Iowa Hospitals and Clinics, Iowa City, IA, USAKate Eichinger - University of Rochester, Rochester, NY, USAMaria Foscan - IRCCS Foundation, Carlo Besta Neurological Institute, Milan, ItalyTimothy Estilow - The Children's Hospital of Philadelphia, and Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USARachel Kennedy - The Royal Children's Hospital, Murdoch Children's Research Institute and University of Melbourne, Melbourne, Victoria, AustraliaKaren Herbert - Sydney Children's Hospitals Network (Randwick and Westmead), Sydney, New South Wales, AustraliaPaula Bray - Sydney Children's Hospitals Network (Randwick and Westmead), Sydney, New South Wales, AustraliaKathryn Refshauge - The University of Sydney, Sydney, New South Wales, AustraliaMonique M Ryan - The Royal Children's Hospital, Murdoch Children's Research Institute and University of Melbourne, Melbourne, Victoria, AustraliaEppie M Yiu - The Royal Children's Hospital, Murdoch Children's Research Institute and University of Melbourne, Melbourne, Victoria, AustraliaMichelle Farrar - School of Women's and Children's Health, University of New South Wales Medicine, Sydney, New South Wales, AustraliaHugo Sampaio - Sydney Children's Hospitals Network (Randwick and Westmead), Sydney, New South Wales, AustraliaIsabella Moroni - IRCCS Foundation, Carlo Besta Neurological Institute, Milan, ItalyEmanuela Pagliano - IRCCS Foundation, Carlo Besta Neurological Institute, Milan, ItalyDavide Pareyson - IRCCS Foundation, Carlo Besta Neurological Institute, Milan, ItalySabrina W Yum - The Children's Hospital of Philadelphia, and Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USADavid N Herrmann - University of Rochester, Rochester, NY, USAGyula Acsadi - Connecticut Children's Medical Center, Hartford, CT, USAMichael E Shy - University of Iowa Hospitals and Clinics, Iowa City, IA, USAJoshua Burns - Sydney Children's Hospitals Network (Randwick and Westmead), Sydney, New South Wales, AustraliaOranee Sanmaneechai - Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand
- Resource Type
- Journal article
- Publication Details
- Brain (London, England : 1878), Vol.141(12), pp.3319-3330
- Publisher
- England
- DOI
- 10.1093/brain/awy280
- PMID
- 30476010
- PMCID
- PMC6312041
- ISSN
- 0006-8950
- eISSN
- 1460-2156
- Grant note
- U54 NS065712 / NINDS NIH HHS
- Language
- English
- Date published
- 12/01/2018
- Academic Unit
- Neurology; Molecular Physiology and Biophysics; Stead Family Department of Pediatrics; Iowa Neuroscience Institute
- Record Identifier
- 9984070751302771
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