title: Rasch-Transformed Total Neuropathy Score clinical version (RT-TNSc(©) ) in patients with chemotherapy-induced peripheral neuropathy.
abstract: Composite scales such as the Total Neuropathy Score clinical version (TNSc(©) ) have been widely used to measure neurological impairment in a standardized manner but they have been criticized due to their ordinal setting having no fixed unit. This study aims to improve impairment assessment in patients with chemotherapy-induced peripheral neuropathy (CIPN) by subjecting TNSc(©) records to Rasch analyses. In particular, we wanted to investigate the influence of factors affecting the use of the TNSc(©) in clinical practice. TNSc(©) has 7 domains (sensory, motor, autonomic, pin-prick, vibration, strength, and deep tendon reflexes [DTR]) each being scored 0-4. Data obtained in 281 patients with stable CIPN were subjected to Rasch analyses to determine the fit to the model. The TNSc(©) did not meet Rasch model's expectations primarily because of misfit statistics in autonomic and DTR domains. Removing these two, acceptable model fit and uni-dimensionality were obtained. However, disordered thresholds (vibration and strength) and item bias (mainly cultural) were still seen, but these findings were kept to balance the assessment range of the Rasch-Transformed TNSc(©) (RT-TNSc(©) ). Acceptable reliability findings were also obtained. A 5-domains RT-TNSc(©) may be a more proper assessment tool in patients with CIPN. Future studies are needed to examine its responsive properties.
authors: Experimental Neurology Unit and Milan Center for Neuroscience, Department of Surgery and Translational Medicine, University of Milan-Bicocca, Monza, Italy.
authors: Davide
authors: D
authors: Binda
authors: Experimental Neurology Unit and Milan Center for Neuroscience, Department of Surgery and Translational Medicine, University of Milan-Bicocca, Monza, Italy.
authors: Guido
authors: G
authors: Cavaletti
authors: Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
authors: David R
authors: DR
authors: Cornblath
authors: Department of Neurology, Maastricht University Medical Center, Maastricht, The Netherlands.|Department of Neurology, Spaarne Hospital, Hoofddorp, The Netherlands.
authors: Ingemar S J
authors: IS
authors: Merkies
mesh_terms: D000367:Age Factors; D004185:Disability Evaluation; D064420:Drug-Related Side Effects and Adverse Reactions / Q000150:complications*; D005260:Female; D006801:Humans; D008297:Male; D010523:Peripheral Nervous System Diseases / Q000139:chemically induced* / Q000503:physiopathology*; D011788:Quality of Life; D012189:Retrospective Studies; D012720:Severity of Illness Index
keywords: Rasch analysis; chemotherapy; peripheral neuropathy; psychometrics; total neuropathy score