ArticleQuality of life research : an international journal of quality of life aspects of treatment, care and rehabilitation2026
Estimating the minimal clinically important difference for the Myasthenia Gravis Quality of Life revised scale (MG-QOL15R).
Article in Quality of life research : an international journal of quality of life aspects of treatment, care and rehabilitation, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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Abstract
purposeTo estimate the minimal clinically important difference (MCID) for the MG-QOL15R.
methodsData from two multi-country myasthenia gravis studies were used: the ADAPT RCT (n = 157) and the MyRealWorld-MG (MRW-MG) survey (n = 92). MCIDs were estimated using four anchor-based methods: change difference (CD), receiver operating characteristic (ROC) curve with Area Under the Curve (AUC), linear regression, and equipercentile linking. MG-Activities of Daily Living (MG-ADL) was the anchor. MCIDs were applied to the ADAPT RCT to assess the impact of different thresholds. Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated to estimate the odds of achieving an MCID threshold at week 4 in the efgartigimod arm compared with placebo among patients positive for acetylcholine receptor antibodies.
resultsBaseline mean age was 46.7 years old in ADAPT and 49.8 years old in MRW-MG; women comprised 71.3% and 71.7%, respectively. ADAPT included only generalized MG, while MRW-MG included 12.0% ocular and 88.0% generalized MG. Average disease severity (MG-ADL 9.0 vs. 6.3) and HRQoL impairment (MG-QOL15R 16.3 vs. 12.0) were greater in ADAPT. MCID estimates were: CD (ADAPT 1.6; MRW-MG 2.8), ROC (both 2.5, AUCs 0.66; 0.71), linear regression (2.1; 1.6), and equipercentile linking (2.0; 3.0). Applying MCIDs of ≥ 2.0 and ≥ 3.0 resulted in ORs of 3.31 (95%CI 1.65–6.87) and 4.14 (95%CI 2.11–8.38).
conclusionsMCID estimates ranged between 1.6 and 3.0 across both studies. MCID thresholds of 2- and 3-points may indicate a minimal clinically meaningful change for monitoring progress and guiding treatment. Future research should use patient global impression of change anchors to improve interpretability and clinical relevance of MCID estimates.
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