Improving and standardising assessment of patients with immune-mediated neuropathies: Peripheral Neuropathy outcome measures Standardisation study (PeriNomS study – part 1)

In this thesis, the outline and the results of the fi rst part of the Peripheral Neuropathy outcome measures Standardisation (PeriNomS) study are described. The PeriNomS study aims to improve and standardise the assessment of patients with immune-mediated neuropathies. These disorders are potentially treatable with immuno-modulating agents, therefore, proper outcome measures are needed to detect clinically important improvement or deterioration over time. Immune-mediated neuropathies include Guillain-Barré syndrome (GBS), chronic infl ammatory demyelinating polyneuropathy (CIDP), polyneuropathy associated with monoclonal gammopathy of undetermined signifi cance (MGUSP), and multifocal motor neuropathy (MMN). Electrophysiological examination in these patients generally reveals features of a demyelinating polyneuropathy, although a subgroup of GBS patients may have predominantly axonal features (acute motor axonal neuropathy (AMAN)). Diagnostic criteria for all these neuropathies have been formulated.1-4 From a clinical, electrophysiological, and immunological point of view there is increasing evidence that these illnesses represent part of a continuum, mainly separated by their extent of neuromuscular dysfunction, the evolution of weakness over time, and their response to treatment (table 1). In the following, a brief overview of these neuropathies is given with particular emphasis on their clinical presentation

Uttalelse om Bayer CropScience genmodifiserte bomull LLCOTTON25 (EFSA/GMO/NL/2005/13). Vurdert og godkjent av Faggruppe for genmodifiserte organismer

publishedVersio

Uttalelse om Dow AgroSciences genmodifiserte bomull 281-24-236 x 3006-210-23 (EFSA/GMO/NL/2005/16). Vurdert og godkjent av Faggruppe for genmodifiserte organismer

publishedVersio

UTTALELSE OM PIONEER HI-BRED/MYCOGEN SEEDS GENMODIFISERTE MAIS 59122x1507xNK603 (EFSA/GMO/UK/2005/21)

Source at https://vkm.no/Vurderingen av den genmodifiserte herbicidresistente og insektstolerante maishybriden 59122x1507xNK603 fra Pioneer Hi-Bred/Mycogen Seeds er utført av Faggruppe for genmodifiserte organismer under Vitenskapskomiteen for mattrygghet. Mattilsynet (MT) ber Vitenskapskomiteen for mattrygghet om å vurdere den genmodifiserte maishybriden 59122x1507xNK603 til bruk i næringsmidler og fôrvarer

UTTALELSE OM PIONEER HI-BRED/MYCOGEN SEEDS GENMODIFISERT MAIS 1507x59122 (EFSA/GMO/NL/2005/15)

Source at https://vkm.no/Vurderingen av den genmodifiserte herbicidresistente og insektstolerante maislinjen 1507x59122 fra Pioneer Hi-Bred/Mycogen Seeds er utført av Faggruppe for genmodifiserte organismer under Vitenskapskomiteen for mattrygghet. Mattilsynet (MT) ber Vitenskapskomiteen for mattrygghet om å vurdere den genmodifiserte maislinjen 1507x59122 til bruk i næringsmidler og fôrvarer

Genmodifisert maislinje MON810

Source at https://vkm.no/Vurderingen av den insektresistente maislinjen MON 810 er utført av Faggruppe for genmodifiserte organismer under Vitenskapskomiteen for mattrygghet. Vitenskapskomiteen for mattrygghet er blitt bedt av Direktoratet for naturforvalting om å foreta en vurdering av miljørisiko i forbindelse med nasjonal sluttbehandling av søknad om godkjenning av MON 810 for alle bruksområder

Outcome measures in immune-mediated neuropathies: the need to standardize their use and to understand the clinimetric essentials

Peripheral neurological disorders like neuropathies may cause impairments (such as weakness and sensory deficits), which may lead to problems in daily life and social functioning with a possible decrement in quality of life expectations. Choosing the proper outcome measure to evaluate the therapeutic efficacy of an intervention at one of these levels of outcome should therefore be considered as fundamental to the design of randomized trials in peripheral neurological disorders. However, these choices are dependent not only on the proposed research purposes but also, and perhaps more importantly, on the fulfillment of the scientific needs of these measures. With an increasing demand for accuracy, a thorough and comprehensive evaluation of an outcome measure is needed to determine its simplicity, communicability, validity, reliability, and responsiveness before being clinically applicable, techniques that are being captured by the science of clinimetrics. Most neurologists are still unfamiliar with these rigorous methodological essentials or overlook some of them in their trial preparations because these are considered time consuming and mind numbing. This review will highlight, against the background of the international classification framework and clinimetric needs for outcome measures, the selected scales applied in published randomized controlled trials in patients with Guillain-Barre syndrome, chronic inflammatory demyelinating polyradiculoneuropathy, multifocal motor neuropathy, and gammopathy-related neuropathies. The need for comparison responsiveness studies between equally valid and reliable measures and to standardize their use is emphasized in these conditions. Finally, specific recommendations are given to move from classic to modern clinimetric approach when constructing, evaluating, and selecting outcome measures using new methods like Rasch analysis, accentuating the need of shifting toward a more modern era