title: Comparison between the European and North American protocols for diagnosis of malignant hyperthermia susceptibility in humans.
abstract: We compared the diagnostic outcome of in vitro contracture tests for diagnosis of malignant hyperthermia susceptibility performed according to the European Malignant Hyperthermia Group protocol and the North American Malignant Hyperthermia Group protocol. The aim of the study was to compare the two major diagnostic tests of malignant hyperthermia susceptibility to have basic data for a common worldwide protocol. We evaluated 156 patients and 17 control individuals. The accordance in diagnostic outcome was 87%. The diverging outcomes between the two protocols were found in a group of patients reacting in few muscle strips and close to the cutoff limits. A 100% accordance in diagnostic outcome was found in individuals with contractures in at least five of six tested muscle strips. In both protocols, contractures close to the cutoff limits in a few muscle strips in scientific studies should be considered as unknown results.
  
  
  CONCLUSIONS
  We compared the two major protocols for investigating malignant hyperthermia susceptibility. There was 87% accordance in diagnostic outcome. The diverging outcomes were seen in individuals with less reproducible test results near the cutoff limits. In scientific studies, such results should be considered as unknown.
mesh_terms: D002110:Caffeine; D006221:Halothane; D006801:Humans; D008305:Malignant Hyperthermia / Q000175:diagnosis*; D009119:Muscle Contraction / Q000187:drug effects; D012680:Sensitivity and Specificity