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The diagnostic accuracy of selected neurological tests

journal contribution
posted on 06.12.2017, 00:00 by S Sullivan, G Hammond-Tooke, Anthony SchneidersAnthony Schneiders, A Gray, P McCrory
The diagnostic value and reliability of selected neurological clinical tests was studied in control subjects with normal neuroimaging (n = 42), and subjects with a focal brain lesion (n = 38). The items were studied by two examiners blinded to group membership and using standardized protocols, and subsequentlyby a neurologist who was not blinded to diagnosis. The positive likelihood ratios ranged from1.06 (pronator drift) to 22.11 (single leg stance with eyes open, while the negative likelihood ratios ranged from 0.47 (tandem gait) to 0.97 (pupil symmetry). Three items (single leg stance – eyesclosed – firm surface; single leg stance – eyes open – foam surface; and tandem gait) successfully distinguished between the two groups (odds ratio p < 0.05). The inter-rater reliability was generally poor, with only tandem gait showing excellent agreement (kappa [K] = 0.92). Tandem gait was the only item to show noteworthy agreement (K = 0.93) between the examiners and the neurologist. The tests varied considerably in their ability to detect radiologically demonstrated structural brain lesions, and several items were poorly reproducible, questioning their value as part of a routine neurological examination.

Funding

Category 1 - Australian Competitive Grants (this includes ARC, NHMRC)

History

Volume

19

Issue

3

Start Page

423

End Page

427

Number of Pages

5

eISSN

1532-2653

ISSN

0967-5868

Location

United Kingdom

Publisher

Churchill Livingstone

Language

en-aus

Peer Reviewed

Yes

Open Access

No

External Author Affiliations

Not affiliated to a Research Institute; University of Melbourne; University of Otago;

Era Eligible

Yes

Journal

Journal of clinical neuroscience.