The extrapolated reference values procedure: Theory, algorithm, and results in patients and control subjects

ABSTRACT Introduction: Reference values (RVs) are required to separate normal from abnormal values obtained in electrodiagnostic (EDx) testing. However, it is frequently impractical to perform studies on control subjects to obtain RVs. The Extrapolated Reference Values (E‐Ref) procedure extracts RVs...

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Bibliographic Details
Published inMuscle & nerve Vol. 57; no. 1; pp. 90 - 95
Main Authors Nandedkar, Sanjeev D., Sanders, Donald B., Hobson‐Webb, Lisa D., Billakota, Santoshi, Barkhaus, Paul E., Stålberg, Erik V.
Format Journal Article
LanguageEnglish
Published United States Wiley Subscription Services, Inc 01.01.2018
Subjects
Algorithms
CMAP amplitude
Computer simulation
Data Interpretation, Statistical
distal latency
Electrodiagnosis - statistics & numerical data
Electromyography - statistics & numerical data
extrapolated normal
Female
Humans
jitter
Male
Middle Aged
Muscles
Myasthenia
Myasthenia gravis
Myasthenia Gravis - physiopathology
Nerve conduction
Neural Conduction
Neuromuscular junctions
Normal Distribution
normal values
Patients
Reference Values
Reproducibility of Results
Vibration
normal values
reference values
jitter
CMAP amplitude
distal latency
extrapolated normal
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Summary:ABSTRACT Introduction: Reference values (RVs) are required to separate normal from abnormal values obtained in electrodiagnostic (EDx) testing. However, it is frequently impractical to perform studies on control subjects to obtain RVs. The Extrapolated Reference Values (E‐Ref) procedure extracts RVs from data obtained during clinically indicated EDx testing. We compared the E‐Ref results with established RVs in several sets of EDx data. Methods: The mathematical basis for E‐Ref was explored to develop an algorithm for the E‐Ref procedure. To test the validity of this algorithm, it was applied to simulated and real jitter measurements from control subjects and patients with myasthenia gravis, and to nerve conduction studies from patients with various conditions referred for EDx studies. Results: There was good concordance between E‐Ref and RVs for all evaluated data sets. Discussion: E‐Ref is a promising method to develop RVs. Muscle Nerve 57: 90–95, 2018
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ISSN:0148-639X
1097-4598
1097-4598
DOI:10.1002/mus.25606