Introduction: Uniform case definitions are required to ensure harmonised reporting of neurological syndromes associated with SARS-CoV-2. Moreover, it is unclear how clinicians perceive the relative importance of SARSCoV-2 in neurological syndromes, which risks under- or over-reporting. Methods: We invited clinicians through global networks, including the World Federation of Neurology, to assess ten anonymised vignettes of SARS-CoV-2 neurological syndromes. Using standardised case definitions, clinicians assigned a diagnosis and ranked association with SARS-CoV-2. We compared diagnostic accuracy and assigned association ranks between different settings and specialties and calculated inter-rater agreement for case definitions as "poor" (kappa <= 0.4), "moderate" or "good" (kappa > 0.6). Results: 1265 diagnoses were assigned by 146 participants from 45 countries on six continents. The highest correct proportion were cerebral venous sinus thrombosis (CVST, 95.8%), Guillain-Barre ' syndrome (GBS, 92.4%) and headache (91.6%) and the lowest encephalitis (72.8%), psychosis (53.8%) and encephalopathy (43.2%). Diagnostic accuracy was similar between neurologists and non-neurologists (median score 8 vs. 7/10, p = 0.1). settings with few neurologists. However, encephalopathy, encephalitis, and psychosis were often misdiagnosed,
Global uncertainty in the diagnosis of neurological complications of SARS-CoV-2 infection by both neurologists and non-neurologists: An international inter-observer variability study / Tamborska, A.A.; Wood, G.K.; Westenberg, E.; Garcia-Azorin, D.; Webb, G.; Schiess, N.; Netravathi, M.; Baykan, B.; Dervaj, R.; Helbok, R.; Lant, S.; Özge, A.; Padovani, A.; Saylor, D.; Schmutzhard, E.; Easton, A.; Lilleker, J.B.; Jackson, T.; Beghi, E.; Ellul, M.A.; Frontera, J.A.; Pollak, T.; Nicholson, T.R.; Wood, N.; Thakur, K.T.; Solomon, T.; Stark, R.J.; Winkler, A.S.; Michael, B.D.; Abbariao, Maritoni; Zaki, Shafiq Dexter Abou; Aleksic, Dejan; Aliling, Nicole; Rivas, Susana Arias; Artajos, Godard; Asukile, Melody; Atalar, Arife Çimen; Bae, Jong Seok; Banzrai, Chimeglkham; Bar, Michal; Barone, Valentina; Baykan, Betul; Beghi, Ettore; Berger, Thomas; Bilic, Ivica; Biller, Jose; Boskovic, Mateja; Cabreira, Verónica; Calado, Sofia; Canete, Maria Teresa; Celebisoy, Nese; Chen, Ike Leon; Chishimba, Lorraine; Chomba, Mashina; Constantino, Glenn Anthony; Cotelli, Maria Sofia; De Cauwer, Harald; Debroucker, Thomas; Orantes, Luis Del Carpio; Devaraj, Rashmi; D'Souza, Michelle; Ekizoglu, Esme; Elmali, Ayse Deniz; Fonseca, Ana Catarina; Furloni, Roberto; Gajre, Sunil; Azorin, David Garcia; Garfoot, Vanessa; Gasparic, Irena; Genç, Hamit; Glavica, Marinka; Guanaes, Luiz Gustavo; Gürsoy, Gizem; Hafiz, Nauman; Hasırcı, Buse; Helbok, Raimund; Hor, Chee Peng; Hughes, Stella; Hwang, Sungeun; Kaya, Irem Ilgezdi; Jakupi, Adi; Jamora, Roland Dominic; Kahwagi, Jamil; Kaprelyan, Ara; Kawatu, Nfwama; Kim, Manho; Kim, Hyunji; Kim, Hyun Kyung; Koffie, Desmond; Ladeira, Filipa; Lant, Suzannah; Lee, Woo-Jin; Lee, Sukyoon; Leonardo, Zerlyn; Lim, Christian Emmanuel; Lisak, Marijana; Loh, Hong Chuan; Loo, Lay Khoon; Huzjan, Arijana Lovrencic; Koh, Rosie Sue Luan Lu; Luabeya, Mesu'a Kabwa; Lugaresi, Alessandra; Macrohon, Bernadette; Majdak, Maja; Manalili, Sheryl; Manelli, Filippo; Mapoure, Yacouba Njankouo; Mascarella, Davide; Massano, João; Mataa, Mataa; Matibag, Jessica Leika; Matic-Gerodias, Alexandria; McMullen, Kate; Miranda, Miguel; Modequillo, Margaret; Shoab, Abul Kalam Mohammed; Motto, Cristina; Murphy, Sinead M.; Mwendaweli, Naluca; Ng, Chen Fei; Ng, Rong Xiang; Ihsan, Mohd Khairul Nizam Nor; Nyein, Aye Myat; O'Connell, Karen; Oh, Seong-il; Ohnmar, Ohnmar; Özge, Aynur; Pajo, Azalea; Palavra, Filipe; Panteleienko, Larysa; Payne, Catherine; Pensato, Umberto; Peres, João; Peters, Steven; Polat, Burcu; Poljakovic, Zdravka; Punter, Martin Nicholas Michael; Quiles, Liz Edenberg; Ranieri, Angelo; Ratković, Marija; Renales, Maria Lina; Robles, Jose; Bedeković, Marina Roje; Rommer, Paulus; Šapina, Lidija; Sarac, Helena; Saylor, Deanna; Schmutzhard, Erich; Sharma, Anahita; Šimić, Aleksandra; Sipilä, Jussi O.T.; Sokhi, Dilraj; Stagno, Mauro; Stancheva, Kristina; Stojsavljević, Marija; Subir, Ahamed; Surdhar, Sushee; Talabucon, Loreto; Tan, Hui Jan; Teoh, Sing Chiek; Vallejo, Dionis; Velioglu, Sibel K.; Vukasović, Rafaela; Kit, Wong Wai; Welte, Tamara; Willekens, Barbara; Yesilot, Nilufer; Yesilot, Nilufer; Yu, Jeryl Ritzi T.; Zaw, Moe Moe; Zhelyazkova, Sashka; Žitnik, Eva. - In: JOURNAL OF THE NEUROLOGICAL SCIENCES. - ISSN 0022-510X. - ELETTRONICO. - 449:(2023), pp. 120646.120646-120646.120652. [10.1016/j.jns.2023.120646]
Global uncertainty in the diagnosis of neurological complications of SARS-CoV-2 infection by both neurologists and non-neurologists: An international inter-observer variability study
Barone, Valentina;Lugaresi, AlessandraMembro del Collaboration Group
;Mascarella, Davide;
2023
Abstract
Introduction: Uniform case definitions are required to ensure harmonised reporting of neurological syndromes associated with SARS-CoV-2. Moreover, it is unclear how clinicians perceive the relative importance of SARSCoV-2 in neurological syndromes, which risks under- or over-reporting. Methods: We invited clinicians through global networks, including the World Federation of Neurology, to assess ten anonymised vignettes of SARS-CoV-2 neurological syndromes. Using standardised case definitions, clinicians assigned a diagnosis and ranked association with SARS-CoV-2. We compared diagnostic accuracy and assigned association ranks between different settings and specialties and calculated inter-rater agreement for case definitions as "poor" (kappa <= 0.4), "moderate" or "good" (kappa > 0.6). Results: 1265 diagnoses were assigned by 146 participants from 45 countries on six continents. The highest correct proportion were cerebral venous sinus thrombosis (CVST, 95.8%), Guillain-Barre ' syndrome (GBS, 92.4%) and headache (91.6%) and the lowest encephalitis (72.8%), psychosis (53.8%) and encephalopathy (43.2%). Diagnostic accuracy was similar between neurologists and non-neurologists (median score 8 vs. 7/10, p = 0.1). settings with few neurologists. However, encephalopathy, encephalitis, and psychosis were often misdiagnosed,I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
