{"title":"Diagnostic utility of Gold Coast criteria for amyotrophic lateral sclerosis in Asia.","authors":"Ryo Otani, Kazumoto Shibuya, Toshio Shimizu, Takamasa Kitaoji, Yu-Ichi Noto, Kota Bokuda, Hideki Kimura, Tomoki Suichi, Keigo Nakamura, Hiroki Kano, Marie Morooka, Yuya Aotsuka, Moeko Ogushi, Sonoko Misawa, Satoshi Kuwabara","doi":"10.1080/21678421.2024.2303062","DOIUrl":null,"url":null,"abstract":"<p><p><i>Objective</i>: This study aimed to reveal the diagnostic utility of Gold Coast (GC) criteria in Japanese patients with amyotrophic lateral sclerosis (ALS) by comparing the sensitivity/specificity with revised El Escorial (R-EE) and Awaji criteria, because its utility has not been studied in Asian ALS. <i>Methods</i>: Consecutive 639 patients (529 with ALS and 110 with ALS mimics), who were suspected of ALS and referred to three Japanese ALS centers, were enrolled. Diagnostic accuracy and characteristics of false positive and negative in GC criteria were compared with those of the Awaji and R-EE criteria. Patients were categorized as definite, probable or possible ALS according to each criterion. <i>Results</i>: The sensitivity of GC criteria (96.8%, 95% confidence interval [CI]: 95.3-98.3%) was higher than that of Awaji (89.6%, 95% CI: 87.0-92.2%) and R-EEC (89.2, 95% CI: 86.6-91.8%) criteria (both, <i>p</i> < 0.001). The specificity was also higher with GC criteria (77.3%, 95% CI: 69.5-85.1%) than Awaji (65.5%, 95% CI: 56.6-74.4%) and R-EEC (66.4, 95% CI: 57.6-75.2%) criteria (both, <i>p</i> < 0.01). Using GC criteria, patients with cervical spondylosis and Parkinson's syndrome tended to be diagnosed with ALS (i.e. \"false positive\"). Additionally, ALS patients diagnosed only by GC criteria less frequently had upper motor neuron (UMN) signs, compared with the other two criteria. <i>Conclusion</i>: Gold Coast criteria improve diagnostic accuracy for ALS in an Asian population, especially in patients with subtle UMN signs.</p>","PeriodicalId":72184,"journal":{"name":"Amyotrophic lateral sclerosis & frontotemporal degeneration","volume":null,"pages":null},"PeriodicalIF":0.0000,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Amyotrophic lateral sclerosis & frontotemporal degeneration","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1080/21678421.2024.2303062","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/1/16 0:00:00","PubModel":"Epub","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 0
Abstract
Objective: This study aimed to reveal the diagnostic utility of Gold Coast (GC) criteria in Japanese patients with amyotrophic lateral sclerosis (ALS) by comparing the sensitivity/specificity with revised El Escorial (R-EE) and Awaji criteria, because its utility has not been studied in Asian ALS. Methods: Consecutive 639 patients (529 with ALS and 110 with ALS mimics), who were suspected of ALS and referred to three Japanese ALS centers, were enrolled. Diagnostic accuracy and characteristics of false positive and negative in GC criteria were compared with those of the Awaji and R-EE criteria. Patients were categorized as definite, probable or possible ALS according to each criterion. Results: The sensitivity of GC criteria (96.8%, 95% confidence interval [CI]: 95.3-98.3%) was higher than that of Awaji (89.6%, 95% CI: 87.0-92.2%) and R-EEC (89.2, 95% CI: 86.6-91.8%) criteria (both, p < 0.001). The specificity was also higher with GC criteria (77.3%, 95% CI: 69.5-85.1%) than Awaji (65.5%, 95% CI: 56.6-74.4%) and R-EEC (66.4, 95% CI: 57.6-75.2%) criteria (both, p < 0.01). Using GC criteria, patients with cervical spondylosis and Parkinson's syndrome tended to be diagnosed with ALS (i.e. "false positive"). Additionally, ALS patients diagnosed only by GC criteria less frequently had upper motor neuron (UMN) signs, compared with the other two criteria. Conclusion: Gold Coast criteria improve diagnostic accuracy for ALS in an Asian population, especially in patients with subtle UMN signs.
研究目的本研究旨在通过比较黄金海岸(GC)标准与修订版埃斯科里亚尔(R-EE)标准和淡路标准的敏感性/特异性,揭示黄金海岸标准在日本肌萎缩性脊髓侧索硬化症(ALS)患者中的诊断效用,因为该标准在亚洲 ALS 中的效用尚未得到研究。研究方法连续招募了 639 名疑似 ALS 患者(529 名 ALS 患者和 110 名 ALS 拟态患者),他们被转诊到日本的三个 ALS 中心。比较了 GC 标准与淡路标准和 R-EE 标准的诊断准确性以及假阳性和假阴性的特征。根据每个标准将患者分为明确、可能或可能的 ALS。结果:黄金海岸标准的灵敏度(96.8%,95% 置信区间[CI]:95.3-98.3%)高于淡路标准(89.6%,95% 置信区间:87.0-92.2%)和 R-EEC 标准(89.2,95% 置信区间:86.6-91.8%)(两者均为 p p 结论:黄金海岸标准提高了 ALS 诊断的准确性:黄金海岸标准提高了亚洲人群中肌萎缩性脊髓侧索硬化症的诊断准确性,尤其是对有细微UMN体征的患者。