Outcome measurement in functional neurological disorder: a systematic review and recommendations.

Pick, Susannah; Anderson, David G; Asadi-Pooya, Ali A; Aybek, Selma; Baslet, Gaston; Bloem, Bastiaan R; Bradley-Westguard, Abigail; Brown, Richard J; Carson, Alan J; Chalder, Trudie; Damianova, Maria; David, Anthony S; Edwards, Mark J; Epstein, Steven A; Espay, Alberto J; Garcin, Béatrice; Goldstein, Laura H; Hallett, Mark; Jankovic, Joseph; Joyce, Eileen M; ... (2020). Outcome measurement in functional neurological disorder: a systematic review and recommendations. Journal of neurology, neurosurgery, and psychiatry, 91(6), pp. 638-649. BMJ Publishing Group 10.1136/jnnp-2019-322180

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OBJECTIVES

We aimed to identify existing outcome measures for functional neurological disorder (FND), to inform the development of recommendations and to guide future research on FND outcomes.

METHODS

A systematic review was conducted to identify existing FND-specific outcome measures and the most common measurement domains and measures in previous treatment studies. Searches of Embase, MEDLINE and PsycINFO were conducted between January 1965 and June 2019. The findings were discussed during two international meetings of the FND-Core Outcome Measures group.

RESULTS

Five FND-specific measures were identified-three clinician-rated and two patient-rated-but their measurement properties have not been rigorously evaluated. No single measure was identified for use across the range of FND symptoms in adults. Across randomised controlled trials (k=40) and observational treatment studies (k=40), outcome measures most often assessed core FND symptom change. Other domains measured commonly were additional physical and psychological symptoms, life impact (ie, quality of life, disability and general functioning) and health economics/cost-utility (eg, healthcare resource use and quality-adjusted life years).

CONCLUSIONS

There are few well-validated FND-specific outcome measures. Thus, at present, we recommend that existing outcome measures, known to be reliable, valid and responsive in FND or closely related populations, are used to capture key outcome domains. Increased consistency in outcome measurement will facilitate comparison of treatment effects across FND symptom types and treatment modalities. Future work needs to more rigorously validate outcome measures used in this population.

Item Type:

Journal Article (Review Article)

Division/Institute:

04 Faculty of Medicine > Department of Head Organs and Neurology (DKNS) > Clinic of Neurology

UniBE Contributor:

Aybek, Selma

Subjects:

600 Technology > 610 Medicine & health

ISSN:

1468-330X

Publisher:

BMJ Publishing Group

Language:

English

Submitter:

Chantal Kottler

Date Deposited:

26 Nov 2020 15:56

Last Modified:

12 Mar 2021 19:24

Publisher DOI:

10.1136/jnnp-2019-322180

PubMed ID:

32111637

Uncontrolled Keywords:

clinical neurology conversion disorder functional neurological disorder movement disorders neuropsychiatry

BORIS DOI:

10.7892/boris.145185

URI:

https://boris.unibe.ch/id/eprint/145185

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