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

Pick, S; Anderson, DG; Asadi-Pooya, AA; Aybek, S; Baslet, G; Bloem, BR; Bradley-Westguard, A; Brown, RJ; Carson, AJ; Chalder, T; et al. Pick, S; Anderson, DG; Asadi-Pooya, AA; Aybek, S; Baslet, G; Bloem, BR; Bradley-Westguard, A; Brown, RJ; Carson, AJ; Chalder, T; Damianova, M; David, AS; Edwards, MJ; Epstein, SA; Espay, AJ; Garcin, B; Goldstein, LH; Hallett, M; Jankovic, J; Joyce, EM; Kanaan, RA; Keynejad, RC; Kozlowska, K; LaFaver, K; LaFrance, WC; Lang, AE; Lehn, A; Lidstone, S; Maurer, CW; Mildon, B; Morgante, F; Myers, L; Nicholson, C; Nielsen, G; Perez, DL; Popkirov, S; Reuber, M; Rommelfanger, KS; Schwingenshuh, P; Serranova, T; Shotbolt, P; Stebbins, GT; Stone, J; Tijssen, MA; Tinazzi, M; Nicholson, TR (2020) Outcome measurement in functional neurological disorder: a systematic review and recommendations. J Neurol Neurosurg Psychiatry, 91 (6). pp. 638-649. ISSN 1468-330X https://doi.org/10.1136/jnnp-2019-322180
SGUL Authors: Morgante, Francesca

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Abstract

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: Article
Additional Information: © Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. http://creativecommons.org/licenses/by-nc/4.0/ This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.
Keywords: clinical neurology, conversion disorder, functional neurological disorder, movement disorders, neuropsychiatry, 11 Medical and Health Sciences, 17 Psychology and Cognitive Sciences, Neurology & Neurosurgery
SGUL Research Institute / Research Centre: Academic Structure > Molecular and Clinical Sciences Research Institute (MCS)
Journal or Publication Title: J Neurol Neurosurg Psychiatry
ISSN: 1468-330X
Language: eng
Dates:
DateEvent
15 May 2020Published
28 February 2020Published Online
20 December 2019Accepted
Publisher License: Creative Commons: Attribution-Noncommercial 4.0
Projects:
Project IDFunderFunder ID
UNSPECIFIEDNational Institutes of Healthhttp://dx.doi.org/10.13039/100000002
UNSPECIFIEDMichael J Fox FoundationUNSPECIFIED
UNSPECIFIEDNational Institute for Health Researchhttp://dx.doi.org/10.13039/501100000272
AZV ČR 16-29651Ministry of Health of the Czech RepublicUNSPECIFIED
PubMed ID: 32111637
Go to PubMed abstract
URI: http://openaccess.sgul.ac.uk/id/eprint/111719
Publisher's version: https://doi.org/10.1136/jnnp-2019-322180

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