Evidence map›Paper›PMID 40556475›Full record

ArticleEuropean journal of neurology2025

Validation of the "Patient-Acceptable Symptom State" Question as Outcome Measure in AChR Myasthenia Gravis: A Multicentre, Prospective Study.

Gregorio Spagni, Massimiliano Ugo Verza, Sara Cornacchini, Francesca Beretta, Bo Sun, Antonio Lotti, Silvia Falso, Alessandro Barilaro, Luca Massacesi, Amelia Evoli and 1 more

Abstract readMulticenter StudyValidation Study
PubMed Full text at PMC Publisher
In one paragraph

Article in European journal of neurology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

7 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Article
  3. Review
  4. Article
  5. Italian recommendations for the diagnosis and treatment of myasthenia gravis.Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology · 2026
    Article
  6. Article
  7. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

Gregorio SpagniDepartment of Neurosciences, Psychology, Drug Research and Child Health (NEUROFARBA), University of Florence, Florence, Italy.ORCID 0000-0003-0656-9671
Massimiliano Ugo VerzaDepartment of Neurosciences, Psychology, Drug Research and Child Health (NEUROFARBA), University of Florence, Florence, Italy.
Sara CornacchiniDepartment of Neurosciences, Psychology, Drug Research and Child Health (NEUROFARBA), University of Florence, Florence, Italy.
Francesca BerettaDepartment of Neurosciences, Psychology, Drug Research and Child Health (NEUROFARBA), University of Florence, Florence, Italy.
Bo SunNuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK.
Antonio LottiDepartment of Neurosciences, Psychology, Drug Research and Child Health (NEUROFARBA), University of Florence, Florence, Italy.
Silvia FalsoDepartment of Neurosciences, Catholic University of the Sacred Hearth, Rome, Italy.
Alessandro BarilaroDepartment of Neurosciences and Sensory Organs, Careggi University Hospital, Florence, Italy.
Luca MassacesiDepartment of Neurosciences, Psychology, Drug Research and Child Health (NEUROFARBA), University of Florence, Florence, Italy.
Amelia EvoliDepartment of Neurosciences, Catholic University of the Sacred Hearth, Rome, Italy.ORCID 0000-0002-4644-2299
Valentina DamatoDepartment of Neurosciences, Psychology, Drug Research and Child Health (NEUROFARBA), University of Florence, Florence, Italy.

Funding

The Impact of COVID-19 on People Living with Rare Diseases and Their FamiliesU2CTR002818 · NCATS · CINCINNATI CHILDRENS HOSP MED CTR · PI Maurizio Macaluso, Michael Wagner · 2019 to 2026
$51.2M
Rare Disease Network for Myasthenia GravisU54NS115054 · NINDS · GEORGE WASHINGTON UNIVERSITY · PI HENRY J KAMINSKI · 2019 to 2026
$11.9M
Italian Ministry of Health GR-2021-12375527Ministero dell'Istruzione, dell'Università e della Ricerca PE0000006NCATS NIH HHS U2C TR002818NIHR Academic Clinical Lectureship CL-2021-13-002NINDS NIH HHS U54 NS115054the Myasthenia Gravis Rare Disease Network-MGNet NIH U54 NS115054
6 · The paper itself

Abstract

introductionPatient Acceptable Symptom State (PASS) is emerging as a valuable subjective measure of the overall myasthenia gravis (MG)-related burden. This study aimed at identifying PASS-positive thresholds for the most used clinical scales, investigating whether PASS and MGFA post-intervention status capture different aspects of the disease outcome, and identifying clinical variables associated with PASS=YES response.

methodsAdult AChR-MG patients were prospectively enrolled at two Italian Centres (Rome: index cohort; Florence: validation cohort). PASS thresholds for MG-ADL, QMG, and MG-QOL15r were defined in the index cohort by ROC analysis and validated in the validation cohort; predictors of favorable PASS were identified by multivariable analysis.

resultsThis study included 173 patients (44% females, median age at onset: 53 years). PASS=YES patients had significantly lower median MG-ADL, QMG, and MG-QOL15r scores, with the following thresholds for PASS=YES: MG ADL ≤ 2, QMG ≤ 8 and MG-QOL15r ≤ 6. The MG-ADL (OR = 0.46, 95% CI = 0.36-0.60, p < 0.001), QMG (OR = 0.72, 95% CI = 0.64-0.81, p < 0.001) and MG-QOL15r (OR = 0.76, 95% CI = 0.70-0.84, p < 0.001), were independently associated with a favorable PASS. The degree of ocular involvement in each scale was the strongest negative determinant of PASS=YES.

conclusionsThis study validates the PASS question and highlights the relevance of ocular complaints in patients' perception of MG burden.

Indexed as

Myasthenia GravisPatient Reported Outcome MeasuresAdultAgedFemaleHumansMaleMiddle AgedProspective StudiesQuality of Lifemyasthenia gravisocular symptomsoutcomepatient‐acceptable symptom statepatient‐reported outcome measuresquality of life

Identifiers

PMID40556475
PMCPMC12188101

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.