Pooled data confirm the Gold Coast criteria catch more ALS cases, with less certain specificity

The Gold Coast criteria, proposed in 2020, simplified how neurologists confirm an ALS diagnosis. This analysis pooled the individual records of 3,007 people from five international studies to compare them with the older revised El Escorial and Awaji criteria.

The Gold Coast criteria correctly identified 96% of people who had ALS, compared with 87% for each of the older sets. Specificity, meaning how well they rule out people who do not have ALS, was 68%, slightly lower than the older criteria (72–73%), and the evidence on specificity was rated very low certainty.

The authors suggest the criteria can support earlier diagnosis in specialist settings, alongside careful exclusion of conditions that mimic ALS and repeat assessment over time.