RT Journal Article SR Electronic T1 2277 Diagnostic utility of gold coast criteria in amyotrophic lateral sclerosis JF BMJ Neurology Open JO BMJ Neurol Open FD BMJ Publishing Group Ltd SP A3 OP A3 DO 10.1136/bmjno-2022-ANZAN.8 VO 4 IS Suppl 1 A1 Hannaford, Andrew A1 Pavey, Nathan A1 Bos, Mehdi Van den A1 Geevasinga, Nimesh A1 Menon, Parvathi A1 Shefner, Jeremy A1 Kiernan, Matthew A1 Vucic, Steve YR 2022 UL http://neurologyopen.bmj.com/content/4/Suppl_1/A3.2.abstract AB Objective The diagnosis of amyotrophic lateral sclerosis (ALS) remains problematic, with current diagnostic criteria (revised El Escorial [rEEC] and Awaji) being complex and prone to error. Consequently, the diagnostic utility of the recently proposed Gold Coast criteria was determined in ALS.Methods We retrospectively reviewed 506 patients (302 males, 204 females) to compare the diagnostic accuracy of the Gold Coast criteria to that of the Awaji and rEEC criteria (defined by the proportion of patients categorized as definite, probable, or possible ALS) in accordance with standards of reporting of diagnostic accuracy criteria.Results The sensitivity of Gold Coast criteria (92%, 95% confidence interval [CI] = 88.7–94.6%) was comparable to that of Awaji (90.3%, 95% CI = 86.69–93.2%) and rEEC (88.6, 95% CI = 84.8–91.7%) criteria. Additionally, the Gold Coast criteria sensitivity was maintained across different subgroups, defined by site of onset, disease duration, and functional disability. In atypical ALS phenotypes, the Gold Coast criteria exhibited greater sensitivity and specificity.Interpretation The present study established the diagnostic utility of the Gold Coast criteria in ALS, with benefits evident in bulbar and limb onset disease patients, as well as atypical phenotypes. The Gold Coast criteria should be considered in clinical practice and therapeutic trials.