To validate performance of the MATCH score using an independent paraneoplastic neurological syndrome (PNS) cohort.

Retrospective review of cases with definite or probable PNS who underwent neural specific autoantibody evaluation at Mayo Clinic Neuroimmunology laboratory between January 2001 and December 2021 was performed. MATCH score was calculated for all patients to assess the score’s discriminative ability

186 patients who met the definite or probable PNS criteria were identified. The MATCH score was ≥4 in 31/36 patients who were KLHL11-IgG positive and in 17/150 patients who were KLHL11-IgG negative but positive for other high-risk autoantibodies including CRMP5, ANNA1, PCA1 and amphiphysin, among others, or seronegative to all antibodies. MATCH Score’s sensitivity, specificity, positive and negative predictive value were 86%, 89%, 65% and 96%, respectively. The score showed an excellent discriminative ability with an AUC of 0.924 [95% CI 0.885-0.962].

MATCH score is a sensitive and specific tool to identify patients likely to be KLHL11-IgG positive. Utilization of MATCH score can improve pre-test probability. However, some KLHL11-IgG cases with motor neuronopathy or limbic encephalitis presentation or those without a detectable testicular cancer at the time of initial assessment may potentially be missed.