Evidence map›Paper›PMID 41574407›Full record

ArticleEuropean journal of neurology2026

Does Interrater Variation Influence the Classification According to the Diagnostic Criteria for Multiple Sclerosis?

Nima Mahmoudi, Julius Renne, Franz Felix Konen, Konstantin Fritz Jendretzky, Nora Möhn, Lea Grote-Levi, Stefan Gingele, Martin W Hümmert, Philipp Schwenkenbecher, Alexander Soldatov and 4 more

Abstract read
In one paragraph

Article in European journal of neurology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Review
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

14 authors.

Nima MahmoudiDepartment of Neuroradiology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin, Germany.ORCID 0000-0002-2053-9623
Julius RenneDepartment of Diagnostic and Interventional Neuroradiology, Hannover Medical School, Hannover, Germany.
Franz Felix KonenDepartment of Neurology, Hannover Medical School, Hannover, Germany.
Konstantin Fritz JendretzkyDepartment of Neurology, Hannover Medical School, Hannover, Germany.
Nora MöhnDepartment of Neurology, Hannover Medical School, Hannover, Germany.ORCID 0000-0002-9102-124X
Lea Grote-LeviDepartment of Neurology, Hannover Medical School, Hannover, Germany.
Stefan GingeleDepartment of Neurology, Hannover Medical School, Hannover, Germany.
Martin W HümmertDepartment of Neurology, Hannover Medical School, Hannover, Germany.
Philipp SchwenkenbecherDepartment of Neurology, Hannover Medical School, Hannover, Germany.
Alexander SoldatovDepartment of Diagnostic and Interventional Neuroradiology, Hannover Medical School, Hannover, Germany.
Kurt-Wolfram SühsDepartment of Neurology, Hannover Medical School, Hannover, Germany.
Peter RaabDepartment of Diagnostic and Interventional Neuroradiology, Hannover Medical School, Hannover, Germany.
Thomas SkripuletzDepartment of Neurology, Hannover Medical School, Hannover, Germany.ORCID 0000-0001-8550-335X
Mike P WattjesDepartment of Neuroradiology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin, Germany.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundStudies on interrater agreement in MRI analysis for patients experiencing a first clinical episode suggestive of multiple sclerosis (MS) are limited and outdated. This study aimed to evaluate interrater agreement for lesion identification in the brain, optic nerve, and spinal cord, and to assess variability in applying the 2017 and 2024 McDonald criteria.

methodsSeventy-eight patients underwent a standardized multisequence 3 Tesla MRI of the brain, optic nerves, and spinal cord, analyzed by three readers with varying expertise. Lesions were categorized based on location according to McDonald criteria. Interrater variability was measured using Cohen's κ for pairwise reader comparisons and Fleiss κ for overall agreement.

resultsInterrater agreement ranged from slight to fair for total lesion count and moderate to substantial for lesion presence. The highest agreement occurred for spinal cord lesions (κ = 0.84), periventricular T2 lesions (κ = 0.70), and gadolinium-enhancing brain lesions (κ = 0.75). Classification agreement based on diagnostic criteria was substantial between the 2017 and 2024 McDonald criteria revisions (κ = 0.65).

conclusionsDespite advanced standardized imaging protocols at 3 T, interrater agreement regarding lesion counts does not improve substantially. However, agreement in classifying lesions according to diagnostic criteria is consistent between the 2017 and 2024 criteria.

Indexed as

BrainMagnetic Resonance ImagingMultiple SclerosisOptic NerveSpinal CordAdultFemaleHumansMaleMiddle AgedObserver VariationYoung AdultdemyelinationMcDonald criteriaMR imagingmultiple sclerosisoptic nerveoptic nerve imaging

Identifiers

PMID41574407
PMCPMC12828338

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.