Abstract：
The long exercise test (LET) is used to assess the diagnosis of periodic paralysis (PP), but LET methodology and normal \"cutoff\" values vary.
To determine optimal LET methodology and cutoffs, we reviewed LET data (abductor digiti minimi motor response amplitude, area) from 55 patients with PP (32 genetically definite) and 125 controls. Receiver operating characteristic curves were constructed, and area under the curve (AUC) was calculated to compare (1) peak-to-nadir versus baseline-to-nadir methodologies and (2) amplitude versus area decrements. Using bayesian principles, we calculated optimal cutoff decrements that achieved 95% posttest probability of PP for various pretest probabilities (PreTPs).
AUC was highest for peak-to-nadir methodology and equal for amplitude and area decrements. For PreTP ≤ 50%, optimal decrement cutoffs (peak-to-nadir) were > 40% (amplitude) or > 50% (area).
For confirmation of PP, our data endorse the diagnostic utility of peak-to-nadir LET methodology using 40% amplitude or 50% area decrement cutoffs for PreTP ≤50%. Muscle Nerve 59:47-54, 2019.
To determine optimal LET methodology and cutoffs, we reviewed LET data (abductor digiti minimi motor response amplitude, area) from 55 patients with PP (32 genetically definite) and 125 controls. Receiver operating characteristic curves were constructed, and area under the curve (AUC) was calculated to compare (1) peak-to-nadir versus baseline-to-nadir methodologies and (2) amplitude versus area decrements. Using bayesian principles, we calculated optimal cutoff decrements that achieved 95% posttest probability of PP for various pretest probabilities (PreTPs).
AUC was highest for peak-to-nadir methodology and equal for amplitude and area decrements. For PreTP ≤ 50%, optimal decrement cutoffs (peak-to-nadir) were > 40% (amplitude) or > 50% (area).
For confirmation of PP, our data endorse the diagnostic utility of peak-to-nadir LET methodology using 40% amplitude or 50% area decrement cutoffs for PreTP ≤50%. Muscle Nerve 59:47-54, 2019.
摘要：
长时间运动测试（LET）用于评估周期性瘫痪（PP）的诊断，但LET方法和正常的“截止”值有所不同。
为了确定最佳LET方法和截止值，我们回顾了LET数据(腹肌最小运动响应幅度，面积）来自55例PP患者（32例遗传明确）和125例对照。构建了接收器工作特性曲线，计算曲线下面积(AUC)以比较(1)峰-最低点与基线-最低点的方法和(2)振幅与面积递减。使用贝叶斯原理，对于各种预测试概率（PreTP），我们计算了实现PP的95％后测概率的最佳截止递减。
峰-底方法的AUC最高，振幅和面积递减的AUC相同。对于PreTP≤50%,最佳衰减截止值(峰底)>40%(振幅)或>50%(面积)。
为了确认PP，我们的数据证明,对于PreTP≤50%,采用40%振幅或50%面积减量截止值的峰底LET方法的诊断实用性.肌肉神经59：47-54，2019。
为了确定最佳LET方法和截止值，我们回顾了LET数据(腹肌最小运动响应幅度，面积）来自55例PP患者（32例遗传明确）和125例对照。构建了接收器工作特性曲线，计算曲线下面积(AUC)以比较(1)峰-最低点与基线-最低点的方法和(2)振幅与面积递减。使用贝叶斯原理，对于各种预测试概率（PreTP），我们计算了实现PP的95％后测概率的最佳截止递减。
峰-底方法的AUC最高，振幅和面积递减的AUC相同。对于PreTP≤50%,最佳衰减截止值(峰底)>40%(振幅)或>50%(面积)。
为了确认PP，我们的数据证明,对于PreTP≤50%,采用40%振幅或50%面积减量截止值的峰底LET方法的诊断实用性.肌肉神经59：47-54，2019。
