# Translation and validation of the Myasthenia Gravis Activities of Daily Living Questionnaire: Latvian version

## TL;DR

This paper translates and validates a questionnaire for measuring daily living activities in myasthenia gravis patients in Latvia, confirming its reliability and usefulness.

## Contribution

The paper presents a validated Latvian version of the MG-ADL scale, suitable for assessing symptom severity and disease impact in myasthenia gravis patients.

## Key findings

- The MG-ADL-L showed acceptable internal consistency (Cronbach’s α = 0.76) and moderate to very good test-retest agreement.
- The MG-ADL-L correlated moderately with MGQOL15 and MGCS, indicating good construct validity.
- MG-ADL-L scores differed significantly between MGFA groups, supporting its clinical relevance.

## Abstract

Our aim was to translate, adapt and validate the Myasthenia Gravis Activities of Daily Living scale into the Latvian language and to evaluate this instrument (MG-ADL-L) in terms of construct validity and reliability.

We enrolled patients with a confirmed MG diagnosis, who could speak Latvian fluently. We performed translation and adaptation according to the cross-cultural adaptation guidelines for self-reported measures. The patients were evaluated by a physician according to the Myasthenia Gravis Foundation of America classification (MGFA) and using the Myasthenia Gravis Composite Score (MGCS). Patients were asked to complete the MG-ADL-L and the 15-item Myasthenia Gravis Quality of Life (MGQOL15) Internal consistency was evaluated based on Cronbach’s α, reproducibility—Cohen’s weighted kappa and construct validity—Spearman’s correlation between the MG-ADL-L and the MGQOL15 and MGCS. We used the Kruskal–Wallis H test to compare the MG-ADL-L score distribution between the MGFA groups.

38 enrolled patients in the study. There was an acceptable internal consistency (Cronbach’s α = 0.76) and moderate to very good agreement between the test and retest scores (Cohen’s weighted kappa = 0.54 and 0.81). The MG-ADL-L showed a moderate positive correlation with the MGQOL15 (r = 0.5, p = 0.001) and the MGCS (r = 0.62, p < 0.001). There was a significant difference in MG-ADL-L scores between the MGFA groups (p = 0.007).

The MG-ADL-L is a valid and reliable self-reported scale to assess and evaluate symptom severity and the impact of the disease on the lives of patients with MG.