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Awaji criteria improves the diagnostic sensitivity in amyotrophic lateral sclerosis: A systematic review using individual patient data.
- Source :
-
Clinical neurophysiology : official journal of the International Federation of Clinical Neurophysiology [Clin Neurophysiol] 2016 Jul; Vol. 127 (7), pp. 2684-91. Date of Electronic Publication: 2016 Apr 16. - Publication Year :
- 2016
-
Abstract
- Objective: To determine the utility of the Awaji criteria in diagnosing amyotrophic lateral sclerosis (ALS) and to propose a novel modification so as to enhance sensitivity based on results of individual patient data (IPD).<br />Methods: Individual patient data were available from 8 studies comparing the diagnostic accuracy of Awaji and revised El Escorial (rEEC) criteria. The sensitivity of a novel updated Awaji criteria, incorporating a "probable-laboratory supported" category, was also tested.<br />Results: Individual patient data were available from 1086 patients, consisting of 881 ALS and 205 patients with disorders mimicking ALS. Summary sensitivities based on random effects logistic regression modelling disclosed a higher sensitivity of the Awaji criteria (0.70, 95% confidence interval [CI] 0.51-0.83) and updated Awaji criteria (0.73, 95% CI 0.56-0.85) when compared to rEEC (0.58, 95% CI 0.48-0.68). Paired analysis revealed higher sensitivities of Awaji criteria in 4 studies, and of updated Awaji criteria in 7 studies, when compared to rEEC.<br />Conclusion: Individual patient data analysis established a higher sensitivity of Awaji criteria when compared to rEEC. The updated Awaji criteria enhanced the diagnostic sensitivity in limb-onset ALS.<br />Significance: The updated Awaji criteria should be considered in clinical practice and future therapeutic trials.<br /> (Copyright © 2016 International Federation of Clinical Neurophysiology. Published by Elsevier Ireland Ltd. All rights reserved.)
Details
- Language :
- English
- ISSN :
- 1872-8952
- Volume :
- 127
- Issue :
- 7
- Database :
- MEDLINE
- Journal :
- Clinical neurophysiology : official journal of the International Federation of Clinical Neurophysiology
- Publication Type :
- Academic Journal
- Accession number :
- 27212114
- Full Text :
- https://doi.org/10.1016/j.clinph.2016.04.005