title: A comparison of the change in clinical severity scale score and a retrospective physician assessment of neurological outcome in individuals with leprosy associated nerve function impairment after treatment with corticosteroids.
abstract: OBJECTIVE
  To determine whether the measured change in score of a validated clinical severity scale reflected physician assessed improvement in individuals who had received corticosteroid therapy for leprosy associated nerve damage.
  
  
  METHODS
  Patients with nerve function impairment who participated in a randomised controlled trial of corticosteroids were classified into two groups using a retrospectively determined physician assessment of improvement. One group consisted of patients who had recovered or improved the other of patients who were unchanged or had deteriorated. The change in the clinical severity scale scores of these two groups was compared.
  
  
  RESULTS
  The change in the clinical severity scale scores of the 34 eligible individuals in the two groups were significantly different (P = 0.003). Individuals in the group who recovered or improved had a greater change in severity score than those whose nerve function was unchanged or deteriorated.
  
  
  CONCLUSIONS
  The scale for measuring the severity of leprosy Type 1 reactions (T1Rs) and/or nerve function impairment reflects the clinical improvement of individuals with leprosy associated nerve damage.
authors.affiliation: Department of Clinical Research, Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, UK. drstevewalker@hotmail.com
authors.forename: Stephen L
authors.initials: SL
authors.lastname: Walker
authors.forename: Peter G
authors.initials: PG
authors.lastname: Nicholls
authors.forename: Sushmita
authors.initials: S
authors.lastname: Dhakal
authors.forename: Rachel A
authors.initials: RA
authors.lastname: Hawksworth
authors.forename: Murdo
authors.initials: M
authors.lastname: Macdonald
authors.forename: Kishori
authors.initials: K
authors.lastname: Mahat
authors.forename: Shudan
authors.initials: S
authors.lastname: Ruchal
authors.forename: Sushma
authors.initials: S
authors.lastname: Hamal
authors.forename: Deanna A
authors.initials: DA
authors.lastname: Hagge
authors.forename: Kapid Dev
authors.initials: KD
authors.lastname: Neupane
authors.forename: Diana N J
authors.initials: DN
authors.lastname: Lockwood
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D007918:Leprosy / Q000150:complications* / Q000503:physiopathology; D008297:Male; D008775:Methylprednisolone / Q000627:therapeutic use*; D008875:Middle Aged; D018482:Muscle, Skeletal / Q000503:physiopathology; D009422:Nervous System Diseases / Q000188:drug therapy* / Q000209:etiology / Q000503:physiopathology*; D009460:Neurologic Examination; D018696:Neuroprotective Agents / Q000627:therapeutic use; D011239:Prednisolone / Q000627:therapeutic use; D012720:Severity of Illness Index; D013979:Tibial Nerve / Q000503:physiopathology; D014276:Trigeminal Nerve / Q000503:physiopathology; D055815:Young Adult
chemical_list: D018696:Neuroprotective Agents; D011239:Prednisolone; D008775:Methylprednisolone