2.4. Standardized scores

To further assess the burden of disease, standardized scores were integrated in the questionnaire and used in this sub-analysis: MG-QoL15 (Myasthenia gravis quality of life, i.e., MG specific HRQoL) (9), MG-ADL (Myasthenia gravis activities of daily living profile) (10), ESSI-D (ENRICHD Social Support Inventory (11, 12) and HADS-D (Hospital anxiety and depression scale) (13–15). The perceived social support was surveyed with the ESSI-D. Low social support was defined by 18 points or less. In the ESSI-D (5-25-point scale), the higher the score, the better is the patients´ situation. Whereas in the MG-QoL15 (0-60-point scale), the MG-ADL (0-24-point scale) and the HADS-D (0-21-point scale for each sub scale anxiety and depression) a high score indicates a worse situation. In the ESSI-D low social support is defined as a sum score of 18 or less and at least two items with 3 or less points (11).