Evidence map›Paper›PMID 42618698›Full record

SynthesisJournal of neurology2026

Gold Coast criteria for ALS diagnosis: individual participant data meta-analysis.

Nipun Shrestha, Zachary Munn, Aicee Calma, Nathan Pavey, Yukiko Tsuji, Parvathi Menon, Alessandro Padovani, Barbara Risi, Lucia Ferullo, Massimiliano Filosto and 16 more

Abstract readMeta-Analysis
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in Journal of neurology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing 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

0 citing papers in PubMed.

No citing paper in PubMed yet.

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

26 authors.

Nipun ShresthaHealth Evidence Synthesis Recommendation and Impact, School of Public Health, Adelaide University, Adelaide, Australia.
Zachary MunnHealth Evidence Synthesis Recommendation and Impact, School of Public Health, Adelaide University, Adelaide, Australia.
Aicee CalmaBrain and Nerve Research Centre, The University of Sydney, Sydney, Australia.
Nathan PaveyBrain and Nerve Research Centre, The University of Sydney, Sydney, Australia.
Yukiko TsujiBrain and Nerve Research Centre, The University of Sydney, Sydney, Australia.
Parvathi MenonBrain and Nerve Research Centre, The University of Sydney, Sydney, Australia.
Alessandro PadovaniUnit of Neurology, ASST Spedali Civili, Brescia, Italy.
Barbara RisiDepartment of Molecular and Translational Medicine, University of Brescia, Brescia, Italy.
Lucia FerulloDepartment of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy.
Massimiliano FilostoUnit of Neurology, ASST Spedali Civili, Brescia, Italy.
Gordon JewettDepartment of Clinical Neurosciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.
Kazumoto ShibuyaDepartment of Neurology, Graduate School of Medicine, Chiba University, Chiba, Japan.
Ryo OtaniDepartment of Neurology, Graduate School of Medicine, Chiba University, Chiba, Japan.
Toshio ShimizuDepartment of Neurology, Tokyo Metropolitan Neurological Hospital, Tokyo, Japan.
Satoshi KuwabaraDepartment of Neurology, Graduate School of Medicine, Chiba University, Chiba, Japan.
Yu-Ichi NotoKyoto Prefectural University of Medicine, Kyoto, Japan.
Takamasa KitaojiKyoto Prefectural University of Medicine, Kyoto, Japan.
Birger JohnsenDepartment of Clinical Neurophysiology, Aarhus University Hospital, Aarhus, Denmark.
Dongchao ShenDepartment of Neurology, Peking Union Medical College Hospital, Beijing, 100730, China.
Liying CuiDepartment of Neurology, Peking Union Medical College Hospital, Beijing, 100730, China.
Leonard H van den BergDepartment of Neurology, UMC Utrecht Brain Center Rudolf Magnus, Utrecht, The Netherlands.
Ruben P A van EijkDepartment of Neurology, UMC Utrecht Brain Center Rudolf Magnus, Utrecht, The Netherlands.
Philip van DammeDepartment of Neurology, University Hospitals Leuven, Leuven, Belgium.
Matthew C KiernanNeuroscience Research Australia, UNSW Sydney, Randwick, Sydney, Australia.
Lynne Giles *School of Public Health, Adelaide University, Adelaide, Australia.
Steve Vucic *Brain and Nerve Research Centre, The University of Sydney, Sydney, Australia. steve.vucic@sydney.edu.au.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundTo evaluate the diagnostic accuracy of the Gold Coast criteria (GCC) and compare their performance with the revised El Escorial (rEEC) and Awaji criteria in patients with suspected amyotrophic lateral sclerosis (ALS).

methodsEmbase, MEDLINE, and Scopus were searched for English-language studies published between January 1, 2020, and August 11, 2025. Eligible studies assessed the diagnostic accuracy of GCC compared with rEEC and Awaji criteria in suspected ALS. Authors were invited to contribute individual participant data. Data were checked, harmonised, and recoded. A one-stage individual-participant data meta-analysis, adjusted for age and sex, was performed. Diagnostic performance was assessed using pooled sensitivity, specificity, and area under the receiver operating characteristic curve. Risk of bias was assessed using QUADAS-2 and QUADAS-C, and certainty of evidence using GRADE for diagnostic test accuracy. The study was registered with PROSPERO, CRD420251123597.

resultsIndividual participant data were available for 3007 participants from five international studies. GCC demonstrated higher sensitivity than rEEC and Awaji criteria: 0.96 (95% confidence interval [CI] 0.93-0.98) versus 0.87 (95% CI 0.78-0.92) and 0.87 (95% CI 0.78-0.93), respectively. Certainty of evidence for sensitivity was moderate at pre-test probabilities of 50% and 75%, and low at 25%. Specificity was numerically lower for GCC at 0.68 (95% CI 0.53-0.81) compared with rEEC at 0.73 (95% CI 0.59-0.83) and the Awaji criteria at 0.72 (95% CI 0.57-0.83). The certainty of evidence for specificity was rated as very low across all assessed pre-test probabilities (25%, 50%, and 75%).

conclusionsGCC provide a sensitive framework for suspected ALS and may support earlier diagnosis in specialist settings. Specificity was imprecise and heterogeneous, supporting use with mimic exclusion and longitudinal reassessment.

Indexed as

Amyotrophic Lateral SclerosisHumansSensitivity and SpecificityAmyotrophic lateral sclerosisAwaji and revised El Escorila criteriaGold Coast criteria

Identifiers

PMID42618698
PMCPMC13489995

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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.