Please use this identifier to cite or link to this item:
https://wslhd.intersearch.com.au/wslhdjspui/handle/1/8583
Title: | Amyotrophic lateral sclerosis diagnostic index: Toward a personalized diagnosis of ALS |
Authors: | Geevasinga, Nimeshan;Howells, James;Menon, Parvathi;van den Bos, Mehdi;Shibuya, Kazumoto;Matamala, Jose Manuel;Park, Susanna B.;Byth, Karen;Kiernan, Matthew C.;Vucic, Steve |
WSLHD Author: | Geevasinga, Nimeshan;Howells, James;Menon, Parvathi;van den Bos, Mehdi;Shibuya, Kazumoto;Matamala, Jose Manuel;Park, Susanna B.;Byth, Karen;Kiernan, Matthew C.;Vucic, Steve |
Issue Date: | 2019 |
Citation: | Neurology 92(6):e536-e547, 2019 |
Abstract: | OBJECTIVE: The aim of the study was to assess the utility of a novel amyotrophic lateral sclerosis (ALS) diagnostic index (ALSDI).METHODS: A prospective multicenter study was undertaken on patients presenting with suspected ALS. The reference standard (Awaji criteria) was applied to all patients at recruitment. Patients were randomly assigned to a training (75%) and a test (25%) cohort. The ALSDI was developed in the training cohort and its diagnostic utility was subsequently assessed in the test cohort.RESULTS: A total of 407 patients were recruited, with 305 patients subsequently diagnosed with ALS and 102 with a non-ALS mimicking disorder. The ALSDI reliably differentiated ALS from neuromuscular disorders in the training cohort (area under the curve 0.92, 95% confidence interval 0.89-0.95), with ALSDI >=4 exhibiting 81.6% sensitivity, 89.6% specificity, and 83.5% diagnostic accuracy. The ALSDI diagnostic utility was confirmed in the test cohort (area under the curve 0.90, 95% confidence interval 0.84-0.97), with ALSDI >=4 exhibiting 83.3% sensitivity, 84% specificity, and 83.5% diagnostic accuracy. In addition, the diagnostic utility of the ALSDI was confirmed in patients who were Awaji negative at recruitment and in those exhibiting a predominantly lower motor neuron phenotype.CONCLUSION: The ALSDI reliably differentiates ALS from mimicking disorders at an early stage in the disease process.CLASSIFICATION OF EVIDENCE: This study provides Class I evidence that for patients with suspected ALS, the ALSDI distinguished ALS from neuromuscular mimicking disorders. |
URI: | https://wslhd.intersearch.com.au/wslhdjspui/handle/1/8583 |
DOI: | https://dx.doi.org/10.1212/WNL.0000000000006876 |
Journal: | Neurology |
Type: | Journal Article |
Study or Trial: | Research Support, Non-U.S. Gov't |
Facility: | Westmead |
Keywords: | Amyotrophic Lateral Sclerosis Evoked Potentials, Motor Neural Inhibition Neuromuscular Diseases Transcranial Magnetic Stimulation |
Appears in Collections: | Westmead Hospital 2019 - 2024 |
Files in This Item:
There are no files associated with this item.
Items in the repository are protected by copyright, with all rights reserved, unless otherwise indicated.