Contributions
Abstract: P291
Type: Poster
Abstract Category: Clinical aspects of MS - 1 Diagnosis and differential diagnosis
Background: 2010 McDonald criteria for primary progressive multiple sclerosis (PPMS) have not been fully validated, while 2016 MAGNIMS MRI guidelines have not been studied in PPMS yet.
Goals: To assess sensitivity and specificity of 2010 McDonald and 2016 MAGNIMS criteria for PPMS applied to two University Centers retrospective cohorts.
Methods: Patients who were seen at University of California San Francisco and Verona University MS Centers for suspected PPMS were retrospectively identified from existing databases between November 2015 and October 2016. Data were obtained from review of patient charts with adequate documentation of clinical, MRI and cerebrospinal fluid (CSF) status to determine the fulfillment of 2010 McDonald criteria for PPMS and 2016 MAGNIMS guidelines for dissemination in space (DIS) at first visit at study centers. PPMS diagnosis was confirmed at last available visit using stringent criteria (DIS according to 2005 McDonald criteria, dissemination in time according to 2001 McDonald criteria, and exclusion of a better explanation as the “gold standard”).
Results: We included 108 patients with a mean follow-up duration of 10.1±6.6 years. 2010 McDonald criteria sensitivity for PPMS was 92.1% (95%CI: 84.5%-96.8%), while specificity was 57.9% (33.5%-79.8%). The highest combined values of sensitivity and specificity (91.8% [95%CI: 82.9%-96.9%] and 72.2% [46.5%-90.3%]) were achieved by combining 2016 MAGNIMS DIS criteria and the presence of oligoclonal bands or increased IgG index in the CSF.
Interpretation: Our findings suggest that 2010 McDonald criteria for PPMS diagnosis have high sensitivity, while specificity appears to be modest. The substitution of 2016 MAGNIMS criteria for DIS plus the incorporation of CSF status increased specificity without compromising sensitivity.
Disclosure:
Dr. Gajofatto received payments from Merck for participation to advisory boards and travel support.
Source of funding: study supported by a Verona University grant (Cooperint 2015)
Abstract: P291
Type: Poster
Abstract Category: Clinical aspects of MS - 1 Diagnosis and differential diagnosis
Background: 2010 McDonald criteria for primary progressive multiple sclerosis (PPMS) have not been fully validated, while 2016 MAGNIMS MRI guidelines have not been studied in PPMS yet.
Goals: To assess sensitivity and specificity of 2010 McDonald and 2016 MAGNIMS criteria for PPMS applied to two University Centers retrospective cohorts.
Methods: Patients who were seen at University of California San Francisco and Verona University MS Centers for suspected PPMS were retrospectively identified from existing databases between November 2015 and October 2016. Data were obtained from review of patient charts with adequate documentation of clinical, MRI and cerebrospinal fluid (CSF) status to determine the fulfillment of 2010 McDonald criteria for PPMS and 2016 MAGNIMS guidelines for dissemination in space (DIS) at first visit at study centers. PPMS diagnosis was confirmed at last available visit using stringent criteria (DIS according to 2005 McDonald criteria, dissemination in time according to 2001 McDonald criteria, and exclusion of a better explanation as the “gold standard”).
Results: We included 108 patients with a mean follow-up duration of 10.1±6.6 years. 2010 McDonald criteria sensitivity for PPMS was 92.1% (95%CI: 84.5%-96.8%), while specificity was 57.9% (33.5%-79.8%). The highest combined values of sensitivity and specificity (91.8% [95%CI: 82.9%-96.9%] and 72.2% [46.5%-90.3%]) were achieved by combining 2016 MAGNIMS DIS criteria and the presence of oligoclonal bands or increased IgG index in the CSF.
Interpretation: Our findings suggest that 2010 McDonald criteria for PPMS diagnosis have high sensitivity, while specificity appears to be modest. The substitution of 2016 MAGNIMS criteria for DIS plus the incorporation of CSF status increased specificity without compromising sensitivity.
Disclosure:
Dr. Gajofatto received payments from Merck for participation to advisory boards and travel support.
Source of funding: study supported by a Verona University grant (Cooperint 2015)