Value of Multiple Sclerosis Diagnostic Criteria

Transcranial magnetic stimulation enhances the specificity of multiple sclerosis diagnostic criteria: a critical narrative review

“…While the authors could not identify any past research that directly compared Poser and 2017 McDonald criteria, successive iterations of the McDonald criteria have generally been shown to diagnose MS earlier and more frequently than the Poser criteria ( i.e ., enhanced sensitivity) ( Brownlee et al, 2015 ), but with compromised specificity and a higher rate of misdiagnosis ( Tintoré et al, 2003 ). Sensitivity and specificity of the Poser criteria have been estimated at 87% and 94%, respectively ( Engell, 1988 ; Izquierdo et al, 1985 ), whereas sensitivity and specificity of the 2017 McDonald criteria range between 68–100% and 14–61%, respectively ( Filippi et al, 2018 , 2022 ; Gobbin et al, 2019 ; van der Vuurst de Vries et al, 2018 ). In past work, the addition of CMCT did not enhance the sensitivity of the Poser criteria to increase MS diagnoses, but increased specificity and reduced MS misdiagnoses ( Beer, Rösler & Hess, 1995 ).…”

Transcranial magnetic stimulation enhances the specificity of multiple sclerosis diagnostic criteria: a critical narrative review

“…While the authors could not identify any past research that directly compared Poser and 2017 McDonald criteria, successive iterations of the McDonald criteria have generally been shown to diagnose MS earlier and more frequently than the Poser criteria ( i.e ., enhanced sensitivity) ( Brownlee et al, 2015 ), but with compromised specificity and a higher rate of misdiagnosis ( Tintoré et al, 2003 ). Sensitivity and specificity of the Poser criteria have been estimated at 87% and 94%, respectively ( Engell, 1988 ; Izquierdo et al, 1985 ), whereas sensitivity and specificity of the 2017 McDonald criteria range between 68–100% and 14–61%, respectively ( Filippi et al, 2018 , 2022 ; Gobbin et al, 2019 ; van der Vuurst de Vries et al, 2018 ). In past work, the addition of CMCT did not enhance the sensitivity of the Poser criteria to increase MS diagnoses, but increased specificity and reduced MS misdiagnoses ( Beer, Rösler & Hess, 1995 ).…”

Causes of Unexpected Death in Patients With Multiple Sclerosis

“…14 That percentage is higher than ours (14%), but we need to bear in mind that until the mid-1970s, the diagnosis of MS relied on clinical history and neurologic examination alone. 15,16 Subsequently, the advent of tests for evoked potentials, measurement of myelin basic protein in cerebrospinal fluid, and advances in neuroimaging enhanced the sensitivity of the clinical diagnosis of MS. 15,16 In this regard, it is notable that we did not identify any case without clinical history in autopsies conducted in the last 10 years, suggesting that those tests have improved the clinical diagnosis MS. In terms of the location of the lesions in subjects lacking clinical history of MS, all 7 had cerebral lesions; only 2 had lesions in the medulla and 3 in the spinal cord.…”

Application of the 2017 Revised McDonald Criteria for Multiple Sclerosis to Patients With a Typical Clinically Isolated Syndrome

“…Earlier studies used pathologically confirmed CDMS cases to demonstrate that the highest rate of correct diagnoses could be made when using the Poser CDMS criteria. 27,28 Therefore, we accepted the use of CDMS as a proxy to pathological evidence to confirm MS diagnosis.…”

Transcranial magnetic stimulation enhances the specificity of multiple sclerosis diagnostic criteria: a critical narrative review

“…While the authors could not identify any past research that directly compared Poser and 2017 McDonald criteria, successive iterations of the McDonald criteria have generally been shown to diagnose MS earlier and more frequently than the Poser criteria ( i.e ., enhanced sensitivity) ( Brownlee et al, 2015 ), but with compromised specificity and a higher rate of misdiagnosis ( Tintoré et al, 2003 ). Sensitivity and specificity of the Poser criteria have been estimated at 87% and 94%, respectively ( Engell, 1988 ; Izquierdo et al, 1985 ), whereas sensitivity and specificity of the 2017 McDonald criteria range between 68–100% and 14–61%, respectively ( Filippi et al, 2018 , 2022 ; Gobbin et al, 2019 ; van der Vuurst de Vries et al, 2018 ). In past work, the addition of CMCT did not enhance the sensitivity of the Poser criteria to increase MS diagnoses, but increased specificity and reduced MS misdiagnoses ( Beer, Rösler & Hess, 1995 ).…”

Causes of Unexpected Death in Patients With Multiple Sclerosis

“…14 That percentage is higher than ours (14%), but we need to bear in mind that until the mid-1970s, the diagnosis of MS relied on clinical history and neurologic examination alone. 15,16 Subsequently, the advent of tests for evoked potentials, measurement of myelin basic protein in cerebrospinal fluid, and advances in neuroimaging enhanced the sensitivity of the clinical diagnosis of MS. 15,16 In this regard, it is notable that we did not identify any case without clinical history in autopsies conducted in the last 10 years, suggesting that those tests have improved the clinical diagnosis MS. In terms of the location of the lesions in subjects lacking clinical history of MS, all 7 had cerebral lesions; only 2 had lesions in the medulla and 3 in the spinal cord.…”

Application of the 2017 Revised McDonald Criteria for Multiple Sclerosis to Patients With a Typical Clinically Isolated Syndrome

“…Earlier studies used pathologically confirmed CDMS cases to demonstrate that the highest rate of correct diagnoses could be made when using the Poser CDMS criteria. 27,28 Therefore, we accepted the use of CDMS as a proxy to pathological evidence to confirm MS diagnosis.…”

Transcranial magnetic stimulation enhances the specificity of multiple sclerosis diagnostic criteria: a critical narrative review

“…While the authors could not identify any past research that directly compared Poser and 2017 McDonald criteria, successive iterations of the McDonald criteria have generally been shown to diagnose MS earlier and more frequently than the Poser criteria ( i.e ., enhanced sensitivity) ( Brownlee et al, 2015 ), but with compromised specificity and a higher rate of misdiagnosis ( Tintoré et al, 2003 ). Sensitivity and specificity of the Poser criteria have been estimated at 87% and 94%, respectively ( Engell, 1988 ; Izquierdo et al, 1985 ), whereas sensitivity and specificity of the 2017 McDonald criteria range between 68–100% and 14–61%, respectively ( Filippi et al, 2018 , 2022 ; Gobbin et al, 2019 ; van der Vuurst de Vries et al, 2018 ). In past work, the addition of CMCT did not enhance the sensitivity of the Poser criteria to increase MS diagnoses, but increased specificity and reduced MS misdiagnoses ( Beer, Rösler & Hess, 1995 ).…”

Causes of Unexpected Death in Patients With Multiple Sclerosis

“…14 That percentage is higher than ours (14%), but we need to bear in mind that until the mid-1970s, the diagnosis of MS relied on clinical history and neurologic examination alone. 15,16 Subsequently, the advent of tests for evoked potentials, measurement of myelin basic protein in cerebrospinal fluid, and advances in neuroimaging enhanced the sensitivity of the clinical diagnosis of MS. 15,16 In this regard, it is notable that we did not identify any case without clinical history in autopsies conducted in the last 10 years, suggesting that those tests have improved the clinical diagnosis MS. In terms of the location of the lesions in subjects lacking clinical history of MS, all 7 had cerebral lesions; only 2 had lesions in the medulla and 3 in the spinal cord.…”

Application of the 2017 Revised McDonald Criteria for Multiple Sclerosis to Patients With a Typical Clinically Isolated Syndrome

“…Earlier studies used pathologically confirmed CDMS cases to demonstrate that the highest rate of correct diagnoses could be made when using the Poser CDMS criteria. 27,28 Therefore, we accepted the use of CDMS as a proxy to pathological evidence to confirm MS diagnosis.…”