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. 2025 Feb 26;63(3):171–180. doi: 10.1038/s41393-025-01065-1

Table 2.

Results of individual studies assessing the diagnostic accuracy of clinical signs and symptoms in DCM.

Clinical Sign Authors Sensitivity (%) Specificity (%)
Tromner’s sign Chaiyamongkol et al. [26] 94 79
Chang et al. [23] 93.5 100
Soufi et al. [34] 97 35
Babinski Chaiyamongkol et al. [26] 36 100
Cook et al. [19] 7 100
Cook et al. [18] 33 93
Rhee et al. [24] 13 100
Harrop et al. [28] 44 Not reported
Hoffmann Cao et al. [16] 61.6 85.7
Chaiyamongkol et al. [26] 75 93
Grijalva et al. [30] 59.2 49.5
Chang et al. [23] 89.1 100
Cook et al. [19] 31 73
Cook et al. [18] 44 74
Rhee et al. [24] 59 84
Glaser et al. [29] 58 78
Soufi et al. [34] 89 41
Harrop et al. [28] 83 Not reported
Clonus Cook et al. [19] 11 99
Cook et al. [18] 7 96
Rhee et al. [24] 13 100
Inverted supinator sign Chaiyamongkol et al. [26] 75 86
Cook et al. [19] 18 99
Cook et al. [18] 61 78
Rhee et al. [24] 51 81
Hyperreflexia Rhee et al. [24] 72 43
Harrop et al. [28] 85 Not reported
Hyperreflexia of the biceps and triceps Cook et al. [18] 44 70
Hyperreflexia of the biceps Cook et al. [19] 18 96
Rhee et al. [24] 62 49
Soufi et al. [34] 61 74
Hyperreflexia of the triceps Rhee et al. [24] 36 78
Soufi et al. [34] 40 92
Hyperreflexia at the patella Cook et al. [19] 22 97
Rhee et al. [24] 33 76
Hyperreflexia at the Achilles Cook et al. [19] 15 98
Rhee et al. [24] 26 81
Hyperreflexia at brachioradialis Rhee et al. [24] 21 89
Suprapatellar reflex Cook et al. [18] 56 33
Absence of deep tendon reflexes Philips [33] 13 84
Hand withdrawal reflex Cook et al. [18] 39 63
Gait deviation Cook et al. [19] 19 94
Tandem gait Soufi et al. [34] 66 84
Sensory impairment Harrop et al. [28] 72 88
Philips [33] 40 46
Motor impairment Archer et al. [32] 53 64
Philips [33] 75 18
Weakness and wasting of deltoid muscles and shoulder girdle Philips [33] 17 88
Grip release test and grip strength Kobayashi et al. [20] 88.2 78.1
10 s step test Machino et al. [31] 92.3 67.8
10 s grip and release test Machino et al. [31] 77.3 58.8
Symptom Authors Sensitivity (%) Specificity (%)
Neck pain Soufi et al. [34] 81 73
Cheung et al. [35] 76 11
Cook et al. [18] 93 18
Neck stiffness Hori et al. [36] 11 87
Gait abnormalities/disturbance Soufi et al. [34] 63 95
Cook et al. [18] 56 52
Autonomic dysfunction Soufi et al. [34] 24 95
Loss of dexterity Cook et al. [18] 72 26
Soufi et al. [34] 52 92
Hand numbness Cook et al. [18] 57 67
Hand paraesthesia Soufi et al. [34] 76 90
Upper extremity weakness Soufi et al. [34] 51 95
Numbness Hori et al. [36] 61 60
Pain Hori et al. [36] 61 60
Tremor Hori et al. [36] 11 93
Cervical vertigo Hori et al. [36] 6 87
Hypalgesia Hori et al. [36] 6 87
Jitteriness Hori et al. [36] 0 93
Apraxia Hori et al. [36] 6 93
Difficulty lifting heavy objects Soufi et al. [34] 75 87
Heightened neck pain when driving or reading Soufi et al. [34]

Driving: 70

Reading: 71

Driving: 90

Reading: 78