82 1. New Besta criteria: at least 1 abnormality in CDT and WDT with MLi and MLe at both feet (8 measurements). 2. At least 1 abnormality in all TTT measurements at both feet (14 measurements). 3. At least 1 abnormality in all TTT measurements at both feet without MLe (12 measurements). 4. At least 2 abnormalities in all TTT measurements at both feet without MLe (12 measurements). Diagnostic accuracy ROC analysis was used to determine sensitivity and specificity. Since QST parameters were investigated, they were not used to classify “diseased” patients. Incorporation bias was avoided by defining patients with sarcoidosis and probable SFN as “diseased”. Additionally, healthy controls were excluded to avoid bias and patients with sarcoidosis without SFN were classified as “healthy”. Diagnostic accuracy was calculated with methods corresponding to the new Besta criteria7 and for all TTT parameters at both hands and feet. In order to improve the clinical feasibility with respect to measuring all TTT parameters at four measuring sites, we investigated whether fewer measurements could be performed without reducing the diagnostic accuracy. We therefore investigated several combinations of TTT parameters and measuring sites. The combination with the highest diagnostic accuracy was used to set a cutoff value for NOAs to define “abnormal QST”. Logistic regression analysis was used to calculate diagnostic accuracy for the combination of the SFNSL questionnaire and the most accurate combination of TTT measurements. The SFNSL score and NOAs for the best combination of TTT parameters and measuring sites were plotted for the three groups: healthy controls, sarcoidosis without SFN and sarcoidosis with probable SFN. We also investigated the correlation between NOAs and SFNSL-score. Results Patient characteristics Figure 1 shows an overview of the inclusion process. A total of 117 participants were included in this study. 20 healthy controls (17%) were included and in 49 patients with sarcoidosis (42%) there were no symptoms or clinical signs of SFN. 48 patients with sarcoidosis (41%) were diagnosed with probable SFN based on symptoms, at least 2 clinical signs and normal nerve conduction studies.6 5 86 5
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