There is an agreement between patients and neurologists in the assessment of myasthenia gravis (MG) symptoms when using the MG Activities of Daily Living (MG-ADL) scale, found a new study published in the journal Muscle and Nerve. “This evidence supports patient self-administration of the MG-ADL in clinical practice and research,” the study authors concluded.

The MG-ADL is a primary endpoint in MG clinical trials. In these, it is often completed by neurologists. However, in observational studies, it is patients who complete the MG-ADL.

Read more about the symptoms of MG

To analyze the concordance between patient- and physician-reported MG-ADL scores, a team of researchers, led by Frauke Stascheit, MD, from Charité -Universitätsmedizin in Berlin, Germany, conducted an international observational study in 137 patients with MG in which consenting patients and physicians completed the MG-ADL. 

The researchers found that physicians reported the symptoms of the disease as being slightly more severe than the patients. 

The intraclass correlation coefficient for the MG-ADL total score between the assessment of the patient and the physician was 0.94, which corresponds to excellent concordance. 

Another statistical analysis showed almost perfect agreement for all items apart from eyelid droop, for which the agreement was moderate.

“Our results demonstrate that patients and neurologists have a concordant assessment of the patient’s MG symptoms when using the MG-ADL scale,” the researchers concluded.

MG is a rare neuromuscular disease affecting the neuromuscular junction and causing symptoms such as double vision, droopy eyelids, and difficulty with swallowing, speech, and/or breathing.

MG-ADL is a scale that assesses 8 MG symptoms. These are talking, chewing, swallowing, double vision, breathing, brushing hair or teeth, eyelid droop, and arising from a chair. The scale assesses the impact of the disease on a patient’s daily life. A higher score corresponds to a more severe disease.


Dewilde S, Janssen MF, Tollenaar NH, et al. Concordance between patient- and physician-reported Myasthenia Gravis Activities of Daily Living (MG-ADL) scores. Muscle Nerve. Published online May 5, 2023. doi:10.1002/mus.27837