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Liu et al. Neuroimmunol Neuroinflammation 2017;4:54-60 Neuroimmunology and
DOI: 10.20517/2347-8659.2016.47
Neuroinflammation

www.nnjournal.net
Topic: Infectious Disease of Central Nervous System Open Access
Developing an international consensus

guidance for myasthenia gravis using

RAND/UCLA appropriateness method

Wei-Bin Liu , Hao Ran , Chuang-Yi Ou , Li Qiu , Zhi-Dong Huang , Zhong-Qiang Lin , Yin-Kai Li , Xiao-Xi Liu ,
1,4
1
1
1
1,4
2
1
1,4
Hao Huang , Wei Fang 3
1,4
1 Department of Neurology, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou 510080, Guangdong, China.
2 School of Pharmacy, Sun Yat-Sen University, Guangzhou 510275, Guangdong, China.
3 School of Earth and Environmental Sciences, Queens College, City University of New York, NY 11367, USA.
4 Guangdong Provincial Key Laboratory for Diagnosis and Treatment of Major Neurological Diseases, Guangzhou 510080, Guangdong, China.
Correspondence to: Dr. Wei Fang, School of Earth and Environmental Sciences, Queens College, City University of New York, 65-30 Kissena Blvd,
Flushing, NY 11367, USA. E-mail: wei.fang@qc.cuny.edu
How to cite this article: Liu WB, Ran H, Ou CY, Qiu L, Huang ZD, Lin ZQ, Li YK, Liu XX, Huang H, Fang W. Developing an international
consensus guidance for myasthenia gravis using RAND/UCLA appropriateness method. Neuroimmunol Neuroinflammation 2017;4:54-60.
Prof. Wei-Bin Liu is currently working as the Director of the Department of Neurology, the First Affiliated Hospital of
Sun Yat-Sen University, and also as PhD supervisor. Additionally, she is appointed as the Vice Director of infectious
diseases and cerebrospinal fluid study group in neurology branch of Chinese Medical Association. Her major research
directions are myasthenia gravis and the inflammatory disease of central nervous system.

ABSTRACT
Article history: Aim: Myasthenia gravis (MG) is a rare and heterogeneous disease for which there is no
Received: 15-11-2016 generally accepted standard of care. Thus, it is critical that MG experts develop consensus
Accepted: 20-03-2017 guidelines based on their practice and disease management to assist clinicians and provide
Published: 30-03-2017 advice for insurance companies, health organizations and institutional review boards.
Methods: An international treatment guidance was developed based on national guidelines
Key words: established in the US, Denmark, Norway, Germany, Japan, Netherlands, United Kingdom
International treatment guidance, and Europe. The RAND/UCLA appropriateness method (RAM) was applied to reach
myasthenia gravis, consensus among 15 worldly renowned experts and experienced clinicians. Results: This
RAND/UCLA appropriateness paper introduced the RAM procedure with its principles and applications and conducted a
method, brief review of the resulting 2016 international consensus guidance for MG in comparison
developing consensus to clinical experience and management of Chinese MG patients. Conclusion: The 2016
international consensus guidance is a major contribution to the treatment and management
of MG, providing an up-to-date expert consensus to assist clinicians around the world,
especially those with limited experience and/or practice in countries/regions that have
limited resources to develop local treatment guidelines. It is also an important contribution
showing how RAM can help to develop consensus guidance for treatment of rare diseases
based on scientific findings and expert experience.
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