Comparison of the King's and MiToS staging systems for ALS.
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ABSTRACT: Objective
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.
SUBMITTER: Fang T
PROVIDER: S-EPMC5425622 | biostudies-literature | 2017 May
REPOSITORIES: biostudies-literature
Publications
Comparison of the King's and MiToS staging systems for ALS.
Fang Ton T Al Khleifat Ahmad A Stahl Daniel R DR Lazo La Torre Claudia C Murphy Caroline C Young Carolyn C Shaw Pamela J PJ Leigh P Nigel PN Al-Chalabi Ammar A
Amyotrophic lateral sclerosis & frontotemporal degeneration 20170105 3-4
<h4>Objective</h4>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).<h4>Methods</h4>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 ...[more]
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