A rasch analysis of the charcot-marie-tooth neuropathy score (CMTNS) in a cohort of charcot-marie-tooth type 1A patients

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Abstract

The Charcot-Marie-Tooth Neuropathy Score (CMTNS) was developed as a main efficacy endpoint for application in clinical trials of Charcot-Marie-Tooth disease type 1A (CMT1A). However, the sensitivity of the CMTNS for measuring disease severity and progression in CMT1A patients has been questioned. Here, we applied a Rasch analysis in a French cohort of patients to evaluate the psychometrical properties of the CMTNS. Overall, our analysis supports the validity of the CMTNS for application to CMT1A patients though with some limitations such as certain items of the CMTNS being more suitable for moderate to severe forms of the disease, and some items being disordered. We suggest that additional items and/or categories be considered to better assess mild-to-moderate patients.

Figures

  • Fig 1. Pairwise correlations between item fit residuals. Pearson correlation coefficients between the residuals of 9 items in the CMTNS. CMAP = Amplitudes of Compound Muscle Action Potentials; SNAP = Amplitudes of Sensory Nerve Action Potentials.
  • Table 1. Item statistics. MSQ = Mean-square.
  • Fig 2. Infit statistics of categories of each item. The x axis displays the infit t-statistics of each category in 9 items. The y axis represents category distributions on the logit scale of latent dimension. Most items fall within the range -2 to 2 (indicated by green lines). CMAP = Amplitudes of Compound Muscle Action Potentials; SNAP = Amplitudes of Sensory Nerve Action Potentials.
  • Fig 3. Person-Item map. The person-item map displays the location of person abilities and item difficulties respectively along the same latent dimension. The person parameter is located on the scale from left (mild impairment) to right (severe impairment). Locations of item difficulties are displayed with solid circles and thresholds of adjacent category locations with open circles. Items with disordered thresholds are marked in red and asterisks. The blue line indicates the zero level of the latent trait.
  • Fig 4. Item Characteristic Curves. Curves represent the probability of selecting a category in an item.
  • Fig 5. Person-Item map of the CMTNS after modification.

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CITATION STYLE

APA

Wang, W., Guedj, M., Bertrand, V., Foucquier, J., Jouve, E., Commenges, D., … Attarian, S. (2017). A rasch analysis of the charcot-marie-tooth neuropathy score (CMTNS) in a cohort of charcot-marie-tooth type 1A patients. PLoS ONE, 12(1). https://doi.org/10.1371/journal.pone.0169878

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