Lou Gehrig gives his farewell speech after being diagnosed with ALS in 1939. Major League Baseball is honoring the slugger Wednesday with the first-ever Lou Gehrig Day. (Credit: Getty Images)

A sim­ple pa­tient sur­vey rev­o­lu­tion­ized ALS drug de­vel­op­ment in the 1990s. Its cre­ator says it may be time for an up­grade

It’s been an­oth­er tough year for ALS ther­a­pies. New tri­als that sparked pa­tient hopes ei­ther fell short of sta­tis­ti­cal sig­nif­i­cance or failed to pro­vide enough ev­i­dence for the FDA to rec­om­mend mov­ing for­ward with­out an­oth­er look. The end re­sult is large­ly more of the same for pa­tients — lit­tle progress in a fa­tal dis­ease with on­ly two ap­proved treat­ments.

That frus­trat­ing slog has stirred pas­sion­ate de­bate with­in the pa­tient and ad­vo­ca­cy com­mu­ni­ties, large­ly around things like tri­al de­sign, com­pas­sion­ate use pro­grams or even what the bar for ap­proval should be. Long over­looked in those dis­cus­sions, how­ev­er, is a tool used to eval­u­ate every ALS ther­a­py that’s draw­ing in­creas­ing scruti­ny.

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