This is a protocol for a Cochrane Review (Diagnostic test accuracy). The objectives are as follows: In view of the likely sequence in which the various diagnostic tests will be used in everyday clinical practice, we have organized this Cochrane review accordingly and our broad goals are to address three related questions. The primary objective of this review is to ascertain the accuracy of anti-AChR antibody testing for the diagnosis of myasthenia gravis (MG). 1) To determine the accuracy of (a) anti-MuSK antibody serological testing; (b) cholinesterase inhibitor testing; (c) RNS; and (d) SFEMG for the diagnosis of MG amongst patients who are seronegative for AChR antibodies. 2) To determine the accuracy of (a) MuSK antibody serological testing; (b) cholinesterase inhibitor testing; (c) RNS; and (d) SFEMG for the diagnosis of MG regardless of the anti-AChR antibody serological status. The rationale for the first secondary objective is that these diagnostic tests are most relevant clinically in the population of patients who are seronegative for AChR antibodies. Since we anticipate that many studies will not separately report the diagnostic accuracy of these other tests for seropositive and seronegative myasthenia, our final objective is to examine the accuracy of these other tests amongst all patients combined (irrespective of whether AChR antibodies titers are elevated or not). The hope is that these data will provide an approximation of the accuracy of other tests for the diagnosis of seronegative myasthenia in the event that we are correct and data to answer our first secondary objective are not available.
ASJC Scopus subject areas
- Pharmacology (medical)