Cuadrado-Corrales, NatividadJiménez-Huete, AdolfoAlbo, CarmenHortigüela, RafaelVega, LuzCerrato, LauraSierra Moros, María JoséRábano, AlbertoPedro-Cuesta, Jesus deCalero, Miguel2019-03-262019-03-262006-07-26BMC Neurol. 2006 Jul 26;6:25.1471-2377http://hdl.handle.net/20.500.12105/7378BACKGROUND: The 14-3-3 test appears to be a valuable aid for the clinical diagnosis of sporadic Creutzfeldt-Jakob disease (sCJD) in selected populations. However, its usefulness in routine practice has been challenged. In this study, the influence of the clinical context on the performance of the 14-3-3 test for the diagnosis of sCJD is investigated through the analysis of a large prospective clinical series. METHODS: Six hundred seventy-two Spanish patients with clinically suspected sCJD were analyzed. Clinical classification at sample reception according to the World Health Organization's (WHO) criteria (excluding the 14-3-3 test result) was used to explore the influence of the clinical context on the pre-test probabilities, and positive (PPV) and negative (NPV) predictive values of the 14-3-3 test. RESULTS: Predictive values of the test varied greatly according to the initial clinical classification: PPV of 98.8%, 96.5% and 45.0%, and NPV of 26.1%, 66.6% and 100% for probable sCJDi (n = 115), possible sCJDi (n = 73) and non-sCJDi (n = 484) cases, respectively. According to multivariate and Bayesian analyses, these values represent an improvement of diagnostic certainty compared to clinical data alone. CONCLUSION: In three different contexts of sCJD suspicion, the 14-3-3 assay provides useful information complementary to clinical and electroencephalographic (EEG) data. The test is most useful supporting a clinical impression, whilst it may show deceptive when it is not in agreement with clinical data.engVoRhttp://creativecommons.org/licenses/by/4.0/14-3-3 ProteinsAdultAgedAtribución 4.0 Internacional16872484612510.1186/1471-2377-6-25BMC neurologyopen access