Portal de Periódicos da CAPES

Awaji criteria improves the diagnostic sensitivity in amyotrophic lateral sclerosis: A systematic review using individual patient data

2016; Elsevier BV; Volume: 127; Issue: 7 Linguagem: Inglês

10.1016/j.clinph.2016.04.005

1872-8952

Nimeshan Geevasinga, Clement T. Loy, Parvathi Menon, Mamede de Carvalho, Michael Swash, Maarten Schrooten, Philip Van Damme, Małgorzata Gaweł, Masahiro Sonoo, Mana Higashihara, Yu‐ichi Noto, Satoshi Kuwabara, Matthew C. Kiernan, Petra Macaskill, Steve Vucic,

Neurogenetic and Muscular Disorders Research

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). 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. 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. 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. The updated Awaji criteria should be considered in clinical practice and future therapeutic trials.