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Neurology 2001;57:1118-1120
© 2001 American Academy of Neurology
Brief Communications

Diagnostic accuracy and certainty from sequential evaluations in peripheral neuropathy

G. A. Suarez, MD, C. H. Chalk, MD, J. W. Russell, MD, S. M. Kim, MD, P. C. O’Brien, PhD and P. J. Dyck, MD

From the Peripheral Neuropathy Research Center (Drs. Suarez and Dyck) and the Section of Biostatistics (Dr. O’Brien), Mayo Clinic and Mayo Foundation, Rochester, MN; the Department of Neurology and GRECC, VAMC (Dr. Russell), University of Michigan, Ann Arbor, MI; the Department of Neurology (Dr. Chalk), Montreal General Hospital, McGill University, Montreal, Quebec, Canada; and the Department of Neurology (Dr. Kim), Yonsei College of Medicine, Seoul, Korea.

Address correspondence and reprint requests to Dr. G.A. Suarez, Mayo Clinic, 200 First St. SW, Rochester, MN 55905; e-mail: suarez.guillermo{at}mayo.edu

Three masked neuromuscular experts analyzed the contribution of the data from sequential evaluations in predicting specific varieties of peripheral neuropathy in 72 patients. The largest improvement (16%) in diagnostic accuracy resulted from presentation of neurologic history. By contrast, diagnostic confidence increased gradually with presentation of additional medical information. Therefore, the authors conclude that for diagnostic accuracy and certainty, expert neuromuscular judgment and extensive characterizing or discriminative testing are needed.




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