A systematic review of diagnostic studies in myasthenia gravis

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168 Scopus citations


We performed a systematic review to identify studies that reported the accuracy of tests for the diagnosis of myasthenia gravis. We identified 20 studies of reasonable, although variable, methodological quality upon which to base estimates of the accuracy of the ice test, rest test, Tensilon test, acetylcholine receptor antibodies, repetitive nerve stimulation and single fiber electromyography for the diagnosis of myasthenia gravis. After examining inter-study heterogeneity for each diagnostic modality, we calculated pooled estimates of sensitivity and specificity as well as positive and negative likelihood ratios. Results are reported separately for ocular and generalized myasthenia. Studies that have examined the performance of anti-acetylcholine receptor antibody testing and single fiber electromyography were generally of better quality than those that examined other diagnostic modalities. We suggest that caution should be exercised in the interpretation of the diagnostic performance of these tests given the methodological limitations of the studies upon which test performance is based.

Original languageEnglish (US)
Pages (from-to)459-467
Number of pages9
JournalNeuromuscular Disorders
Issue number7
StatePublished - Jul 2006
Externally publishedYes


  • Accuracy
  • Diagnosis
  • Likelihood ratio
  • Myasthenia gravis
  • Sensitivity
  • Specificity

ASJC Scopus subject areas

  • Clinical Neurology
  • Pediatrics, Perinatology, and Child Health
  • Developmental Neuroscience
  • Neurology


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