title: AWAJI criteria are not always superior to the previous criteria: A meta-analysis.
abstract: BACKGROUND
  Recently, some authors have claimed that the Awaji criteria (AC) are not always more sensitive than the revised El Escorial criteria (rEEC) in amyotrophic lateral sclerosis (ALS).
  
  
  METHODS
  A meta-analysis examined 2 prospective and 7 retrospective studies, which included 1,121 ALS patients, to compare AC and rEEC for early diagnosis of ALS.
  
  
  RESULTS
  AC led to an 11% greater likelihood of being classified into the categories "clinically definite" or "clinically probable", while if confined to the "clinically probable - laboratory supported (LS)" category, this effect was 40% higher with the rEEC (95% cnfidence interval, 3-82%; I2=98%). Specifically, AC downgraded 20% of the rEEC "clinically probable - LS" category to the AC "clinically possible".
  
  
  CONCLUSIONS
  Despite overall superiority of AC, this meta-analysis shows that it is not always more sensitive than rEEC. These results are related to the requirement for 2 upper motor neuron signs in the AC "clinically probable" category.
authors.affiliation: Department of Medicine, Inje University College of Medicine, Busan, Korea.|University of Missouri-Kansas City, Kansas City, Missouri, USA.
authors.forename: Jae-Sik
authors.initials: JS
authors.lastname: Jang
authors.affiliation: Department of Neurology, Kangdong Sacred Heart Hospital, Hallym University College of Medicine, 150 Seongan-ro, Gangdong-gu, Seoul 134-701, Seoul, Korea.
authors.forename: Jong Seok
authors.initials: JS
authors.lastname: Bae
mesh_terms: D000690:Amyotrophic Lateral Sclerosis / Q000175:diagnosis* / Q000453:epidemiology; D016206:Databases, Bibliographic / Q000706:statistics & numerical data; D003710:Demography; D042241:Early Diagnosis; D004576:Electromyography; D006801:Humans; D012372:ROC Curve
keywords: ALS; Awaji criteria; amyotrophic lateral sclerosis; diagnostic criteria; revised El Esocorial criteria; sensitivity