Difficulties classifying myasthenia gravis in the pediatric surgical literature

We read with interest the manuscript by Derderian et al. [1], and we support their enthusiasm for thymectomy for myasthenia gravis (MG), particularly with respect to minimally invasive techniques. However, we write to register our disappointment with their use of Osserman staging and deFilippi treatment classification, both of which are qualitative in nature and should not be mainstays of contemporary MG literature.