A Comparison of the Validity of the McDonald Diagnostic Criteria for Multiple Sclerosis 2005 vs 2010 in the Clinical Practice

Czech version

Authors: M. Daňová ^1,2; E. Klímová ³
Authors‘ workplace: Pro Magnet, s. r. o, Pracovisko magnetickej rezonancie Prešov, FNsP J. A. Reimana v Prešove ¹; Fakulta zdravotníctva a sociálnej práce Trnavskej univerzity v Trnave ²; Klinika neurológie Fakulty zdravotníckych odborov Prešovskej univerzity v Prešove a FNsP J. A. Reimana v Prešove ³
Published in: Cesk Slov Neurol N 2014; 77/110(2): 181-185
Category: Original Paper

Overview

Background:
We aimed to compare the validity of the second and third version of the McDonald’s Diagnostic Criteria for MS: 2005 versus 2010, based on the evidence of lesions dissemination in space and time using magnetic resonanse imaging (MRI), in predicting the conversion clinically isolated syndrome (CIS) to Clinically Definite Multiple Sclerosis (CDMS).

Method:
From 06/ 2005 to 12/ 2010, the radiologist retrospectively evaluated according to both criteria MRI findings of all patients who completed the first brain MRI examination from the physician indication as suspect CIS‑ MS. Each of these patients were subsequently monitored by the neurologist for at least two years and had at least two controls of brain MRI. Both criteria sensitivity, specificity, positive and negative predictive value (PPV, NPV) were determined.

Results:
Altogether 76 patients were included, of these, 60 were (78.95%) women, the average age at the time of CIS was 29.46 ± 8.55 years. Thirty one patients (40.80%) converted to MS, of these 21 were women (27.63%) and 10 men (13.17 %). The sensitivity of the McDonald’s criteria (2005) was 70.97%, specificity 86.67%, PPV 78.57 % and NPV 81.25%. According to the third revision of McDonald’s criteria (2010), the sensitivity was 93.55%, specificity 84.44%, PPV 80.56% and NPV 95.00%.

Conclusion:
New McDonald’s criteria (2010) have higher sensitivites and comparable specificity than previous criteria (2005) in prediction conversion from CIS to CDMS. Their use significantly shortened the time needed to the disease diagnose in comparison with those of 2005, or the criteria by Poser (1983).

Key words:
multiple sclerosis – diagnostic criteria –clinically isolated syndrome – clinically definite MS – magnetic resonance imaging

The authors declare they have no potential conflicts of interest concerning drugs, products, or services used in the study.

The Editorial Board declares that the manuscript met the ICMJE “uniform requirements” for biomedical papers.

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