Validity of the McDonald criteria in predicting second events in multiple sclerosis.

BACKGROUND

The McDonald criteria are designed for predicting the second event in multiple sclerosis. With several revisions made to the McDonald criteria, the criteria get much easier to use, but what about the diagnostic validity? This research is conducted for evaluating the diagnostic validity of the McDonald criteria in multiple sclerosis.

METHODS

Pubmed, Web of Science, Cochrane Library were systematically searched with keywords of "Multiple sclerosis" and "McDonald criteria" from, January 1, 2010 to 27, February 2020. The methodological quality of each study is assessed by Quality Assessment of Diagnostic Accuracy Studies-2 (QUADAS-2). All of the statistics are analyzed by software STATA 12.0 and Meta-Disc 1.4.

RESULTS

Twenty articles are finally included according to the inclusion and exclusion criteria. Both the 2010 and 2017 McDonald criteria have excellent performance in predicting second events in multiple sclerosis. The 2017 McDonald criteria have better performance compared to the 2010 McDonald criteria (AUC, 0.83 vs 0.77). It is increased in sensitivity but decreased in specificity.

CONCLUSION

The McDonald criteria are useful in predicting second events in multiple sclerosis. The 2017 McDonald criteria have better performance than the 2010 McDonald criteria with increased sensitivity but decreased specificity.