Abstract Details

Title Prospective Validation of Machine-assisted Electrophysiologic and Online Clinical Support Tools in Chronic Inflammatory Demyelinating Polyradiculoneuropathy

Topic Neuromuscular and Clinical Neurophysiology (EMG)

Presentation(s) P7 - Poster Session 7 (8:00 AM-9:00 AM)

Poster/Presentation
Number 9-010

Objective

To validate a machine-assisted electrodiagnostic (EDX) support tool in chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) in conjunction with an online CIDP clinical calculator.

Background CIDP is one of the most common, treatable, autoimmune, demyelinating neuropathies. While the European Academy of Neurology/Peripheral Nerve Society (EAN/PNS) in 2021 published EDX criteria for CIDP, misdiagnosis is common in part due to the complexity of EDX interpretation of demyelination. Previously, our group developed an Excel-based EDX assistant for automated application of 2021-EAN/PNS EDX criteria which formed the basis of an online clinical calculator to identify CIDP versus mimic disorders (). Currently, in collaboration with Cadwell Industries, a CIDP-EDX diagnostic machine-assisted program was developed integrating directly with nerve conduction study software to alert providers in real time when 2021-EAN/PNS CIDP criteria are met.

Design/Methods

We prospectively evaluated 100 consecutive patients with referral or EDX diagnosis of polyradiculoneuropathy beginning January 1, 2024. Fifty patients were included each from Jacksonville and Rochester Mayo Clinics. EMG reports were compared to a machine-assisted support tool applying CIDP 2021-EAN/PNS EDX criteria for demyelination. The EDX-calculator performance was compared to final diagnosis and our previously reported online CIDP clinical prediction tool.

Results

Among 100 patients (60% male; median age 64), 30 had a final CIDP diagnosis with 29 having post-IVIG follow-up, 27 (93%) improved and 2 (7%) stabilized. Routine EMGs reported demyelination in 14 of 30 (46%), with 46% sensitivity and 79% specificity. The EDX calculator supported CIDP demyelination in 28 of 30 (93%), with 93% sensitivity and 57% specificity. The clinical calculator detected CIDP in 30 of 30 (100%) with 86% specificity, increasing to 94% after excluding false positives lacking demyelinating features per the EDX calculator.

Conclusions

A real-time EDX machine-assisted support tool paired with an established clinical web-based calculator assists CIDP assessment facilitating clinical decision-making by improving standardized identification of demyelinating nerve conductions.

Authors/Disclosures
Michael P. Skolka, MD PRESENTER	Dr. Skolka has nothing to disclose.
Grace Swart, MD	Dr. Swart has received research support from National Health and Medical Research Council. Dr. Swart has received personal compensation in the range of $5,000-$9,999 for serving as a MS Masters Forum Attendee (sponsored education) with Merck.
Shahar Shelly, MD (Rambam Medical Center)	Dr. Shelly has or had stock in Remepy.
Thapat Wannarong, MD	Dr. Wannarong has nothing to disclose.
Stefan Stalberg	Mr. Stalberg has received personal compensation for serving as an employee of Stefan Stalberg Software AB.
Benjamin Stalberg	Mr. Stalberg has received personal compensation for serving as an employee of BenZoft.
Abe Gardner (Cadwell Laboratories, Inc)	No disclosure on file
Jacob Price	Mr. Price has received personal compensation for serving as an employee of Cadwell.
Ruple S. Laughlin, MD, FAAN (Mayo Clinic Rochester)	Dr. Laughlin has nothing to disclose.
Divyanshu Dubey, MD, FAAN (Mayo Clinic)	The institution of Dr. Dubey has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Argenx. The institution of Dr. Dubey has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Arialys. The institution of Dr. Dubey has received personal compensation in the range of $500-$4,999 for serving as a Consultant for UCB . Dr. Dubey has received research support from Department of Defense . Dr. Dubey has received research support from Department of Defense . Dr. Dubey has received research support from UCB. Dr. Dubey has received research support from David J. Tomassoni ALS Research Grant Program . Dr. Dubey has received intellectual property interests from a discovery or technology relating to health care. Dr. Dubey has received intellectual property interests from a discovery or technology relating to health care. Dr. Dubey has received intellectual property interests from a discovery or technology relating to health care. Dr. Dubey has received intellectual property interests from a discovery or technology relating to health care.
John R. Mills, MD, PhD (Mayo Clinic)	The institution of Dr. Mills has received research support from Werfen Diagnostics. Dr. Mills has received intellectual property interests from a discovery or technology relating to health care.
Jayawant N. Mandrekar, PhD	Dr. Mandrekar has nothing to disclose.
Christopher J. Klein, MD, FAAN (Mayo Clinic)	Dr. Klein has received personal compensation in the range of $500-$4,999 for serving as a Consultant for NMD Pharma.

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