Clinical neurophysiology : official journal of the International Federation of Clinical Neurophysiology · 2025
Deriving reference limits from historical data - A comparison of four novel methods.
СтатьяСравнительное исследованиеНазвание и аннотация: Перевод в очереди
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Szczepanski Tomasz Szymon, Omland Petter Moe, Dunker Øystein, Sand Trond, Tannemaat Martijn, Reijntjes Robert, Yazidi Anis, Bach Kerstin, Zwart John Anker, Jabre Joe, Nilsen Kristian Bernhard
Аннотация
OBJECTIVE: To compare four novel methods - extrapolated norms (E-norms), extrapolated reference values (E-Ref), multivariable extrapolated reference values (MeRef) and mixture model clustering (MMC) - for obtaining reference limits for nerve conduction studies (NCS) from historical data containing both normal and abnormal studies.
METHODS: Reference limits for 29 commonly clinically used NCS measurements were calculated from a historical database containing measurements from 24618 patients using E-norms, E-ref, MeRef and MMC. The resulting reference limits were compared to reference limits for NCS calculated from 680 healthy subjects using Youden's J statistics.
RESULTS: Except for distal latencies, E-norms produced reference limits with the highest Youden's J statistics with higher sensitivity, but lower specificity. E-Ref, MeRef and MMC produced reference limits with high specificity, but lower sensitivity than E-norms.
CONCLUSIONS: There are substantial differences in the performance of E-norms, E-Ref, MeRef and MMC. A dynamic approach, where the methods used are changed based on the type of NCS measurement and the amount of historical data available, may yield the highest accuracy.
SIGNIFICANCE: When combining the different novel methods, it is possible to create clinically useful reference limits using historical data.
METHODS: Reference limits for 29 commonly clinically used NCS measurements were calculated from a historical database containing measurements from 24618 patients using E-norms, E-ref, MeRef and MMC. The resulting reference limits were compared to reference limits for NCS calculated from 680 healthy subjects using Youden's J statistics.
RESULTS: Except for distal latencies, E-norms produced reference limits with the highest Youden's J statistics with higher sensitivity, but lower specificity. E-Ref, MeRef and MMC produced reference limits with high specificity, but lower sensitivity than E-norms.
CONCLUSIONS: There are substantial differences in the performance of E-norms, E-Ref, MeRef and MMC. A dynamic approach, where the methods used are changed based on the type of NCS measurement and the amount of historical data available, may yield the highest accuracy.
SIGNIFICANCE: When combining the different novel methods, it is possible to create clinically useful reference limits using historical data.