Real-Life Evaluation of the MOGAD Diagnostic Criteria
Journal: Neurology Neuroimmunology & Neuroinflammation; August 19, 2025
Author(s): Sara Carta, Elia Sechi Alessandro Dinoto, Chiara Mancinelli, Giacomo Greco, Giorgia Teresa Maniscalco Sara Cornacchini, Maria Pia Giannoccaro, Francesca Calabria, Alessandro Marziali, Stefano Masciocchi, Mario Risi, Alberto Cossu, Irene Volonghi, Gaetano Cantalupo, Marco Zoccarato, Riccardo Orlandi, Elisabetta Del Zotto, Diana Ferraro, Milena Trentinaglia, Stefano De Biase, Luisa Grazian, Francesca Caleri, Maria Rachele Bianchi, Patrizia Rossi, Eleonora Virgilio, Marco Capobianco, Rosa Cortese, Carla Tortorella, Francesca Rossi, Giovanna De Luca, Anna Perelli, Silvia Bozzetti, Luigi Zuliani, Margherita Nosadini, Stefano Sartori, Laura Brambilla, Alberto Gajofatto, Alberto Vogrig, Luca Massacesi, Valentina Damato, Matteo Gastaldi, and Sara Mariotto
How well do the new diagnostic criteria for MOGAD work in real-life clinical practice? Results from multi-center study in Italy
This study looked at how well recently developed diagnostic criteria for MOGAD work when used in everyday clinical settings in Italy.
The researchers studied the cases of 214 patients who tested positive for MOGAD antibodies across 29 centers in Italy. They applied the 2023 MOGAD diagnostic criteria to these patients and compared the diagnosis based on the criteria with the final diagnosis made by doctors.
Using the new diagnostic criteria, about 79% patients were correctly identified as having MOGAD, while about 4% were incorrectly classified as having MOGAD, and about 11% of true MOGAD cases were missed.
The criteria were good at identifying people who truly had MOGAD (88% sensitivity), but less reliable at ruling it out in people who did not have it (61% specificity).
When the criteria suggested a diagnosis of MOGAD, this was correct in about 95% of cases. But when the criteria suggested that a person did not have MOGAD, this was correct only about 38% of the time.
After a detailed re-review of unclear or incorrect cases, the performance of the criteria improved. The ability of the criteria to correctly identify MOGAD increased to about 99%, and the ability to correctly rule it out improved to about 92%.
Overall the MOGAD criteria worked well across centers in this study, but the researchers recommend that controversial or unclear cases be reviewed and discussed among doctors and reevaluated against the criteria a second time for better accuracy.
Related articles:
Performance of the 2023 diagnostic criteria for MOGAD: real-world application in a Chinese multicenter cohort of pediatric and adult patients
Free Access: Full text
