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The diagnostic accuracy of selected neurological tests
journal contribution
posted on 2017-12-06, 00:00 authored by S Sullivan, G Hammond-Tooke, Anthony SchneidersAnthony Schneiders, A Gray, P McCroryThe 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
19Issue
3Start Page
423End Page
427Number of Pages
5eISSN
1532-2653ISSN
0967-5868Location
United KingdomPublisher
Churchill LivingstonePublisher DOI
Full Text URL
Language
en-ausPeer Reviewed
- Yes
Open Access
- No
External Author Affiliations
Not affiliated to a Research Institute; University of Melbourne; University of Otago;Era Eligible
- Yes