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New diagnostic criteria for neurocysticercosis: Reliability and validity

Carpio, A; Fleury, A; Romo, ML; Abraham, R; Fandiño, J; Durán, JC; Cárdenas, G; ... Sander, JW; + view all (2016) New diagnostic criteria for neurocysticercosis: Reliability and validity. Annals of Neurology , 80 (3) pp. 434-442. 10.1002/ana.24732. Green open access

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Abstract

OBJECTIVE: The diagnosis of neurocysticercosis (NCC) remains problematic due to the heterogeneity of its clinical, immunological, and imaging characteristics. Our aim was to develop and assess a new set of diagnostic criteria for NCC, which might allow for the accurate detection of, and differentiation between, parenchymal and extraparenchymal disease. METHODS: A group of Latin American NCC experts developed by consensus a new set of diagnostic criteria for NCC. A multicenter, retrospective study was then conducted to validate it. The reference standard for diagnosis of active NCC was the disappearance or reduction of cysts after anthelmintic treatment. In total, three pairs of independent neurologists blinded to the diagnosis evaluated 93 cases (with NCC) and 93 controls (without NCC) using the new diagnostic criteria. Mixed-effects logistic regression models were used to estimate sensitivity and specificity. RESULTS: The inter-rater reliability (kappa) of diagnosis among evaluators was 0.60. For diagnosis of NCC vs. no NCC, the validation of the new criteria had a sensitivity of 93.2% and specificity of 81.4%. Parenchymal NCC had a sensitivity of 89.8% and specificity of 80.7% and extraparenchymal NCC had a sensitivity of 65.9% and specificity of 94.9%. INTERPRETATION: These criteria have acceptable reliability and validity and could be a new tool for clinicians and researchers. An advantage of the new criteria is that they consider parasite location (i.e., parenchymal or extraparenchymal), which is an important factor determining the clinical, immunological, and radiological presentation of the disease, and importantly, its treatment and prognosis.

Type: Article
Title: New diagnostic criteria for neurocysticercosis: Reliability and validity
Open access status: An open access version is available from UCL Discovery
DOI: 10.1002/ana.24732
Publisher version: http://doi.org/10.1002/ana.24732
Language: English
Additional information: © 2016 The Authors. Annals of Neurology published by Wiley Periodicals, Inc. on behalf of American Neurological Association.This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use anddistribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made.
Keywords: Case control study, diagnosis, epilepsy, imaging, neurocysticercosis, reliability and validity
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > UCL Queen Square Institute of Neurology
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > UCL Queen Square Institute of Neurology > Clinical and Experimental Epilepsy
URI: https://discovery.ucl.ac.uk/id/eprint/1505881
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