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dc.contributor.authorFang, Ton
dc.contributor.authorAl Khleifat, Ahmad
dc.contributor.authorStahl, Daniel R.
dc.contributor.authorLazo Latorre, Claudia
dc.contributor.authorMurphy, Caroline
dc.contributor.authorLicals, Uk-Mnd
dc.contributor.authorYoung, Carolyn
dc.contributor.authorShaw, Pamela J.
dc.contributor.authorLeigh, P. Nigel
dc.contributor.authorAl-Chalabi, Ammar
dc.description.abstractObjective: To investigate and compare two ALS staging systems, King’s clinical staging and Milano-Torino (MiToS) functional staging, using data from the LiCALS phase III clinical trial (EudraCT 2008-006891-31). Methods: Disease stage was derived retrospectively for each system from the ALS Functional Rating Scale-Revised subscores using standard methods. The two staging methods were then compared for timing of stages using box plots, correspondence using chi-square tests, agreement using a linearly weighted kappa coefficient and concordance using Spearman’s rank correlation. Results: For both systems, progressively higher stages occurred at progressively later proportions of the disease course, but the distribution differed between the two methods. King’s stage 3 corresponded to MiToS stage 1 most frequently, with earlier King’s stages 1 and 2 largely corresponding to MiToS stage 0 or 1. The Spearman correlation was 0.54. There was fair agreement between the two systems with kappa coefficient of 0.21. Conclusion: The distribution of timings shows that the two systems are complementary, with King’s staging showing greatest resolution in early to mid-disease corresponding to clinical or disease burden, and MiToS staging having higher resolution for late disease, corresponding to functional involvement. We therefore propose using both staging systems when describing ALS.ca_ES
dc.description.sponsorshipThis is work from two EU Joint Programme - Neurodegenerative Disease Research (JPND) projects (STRENGTH, ALS-CarE). The projects are supported through the following funding organisations under the aegis of JPND - (United Kingdom, Medical Research Council and Economic and Social Research Council). AAC receives salary support from the National Institute for Health Research (NIHR) Dementia Biomedical Research Unit at South London and Maudsley NHS Foundation Trust and King’s College London. The work leading up to this publication was funded by the European Community’s Health Seventh Framework Programme (FP7/2007–2013; grant agreement number 259867).ca_ES
dc.publisherTaylor & Francisca_ES
dc.relation.isformatofReproducció del document publicat a
dc.relation.ispartofAmyotrophic Lateral Sclerosis and Frontotemporal Degeneration, 2017, vol. 18, núm. 3-4, p. 227-232ca_ES
dc.rightscc-by (c) Fang et al., 2017ca_ES
dc.subjectClinical stageca_ES
dc.subjectMiToS stageca_ES
dc.subjectKing’s stageca_ES
dc.subjectClinical trialsca_ES
dc.titleComparison of the King’s and MiToS staging systems for ALSca_ES

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