{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T22:19:36Z","timestamp":1789165176878,"version":"build-2803163510"},"reference-count":26,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2026,5,19]],"date-time":"2026-05-19T00:00:00Z","timestamp":1779148800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,5,19]],"date-time":"2026-05-19T00:00:00Z","timestamp":1779148800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100006095","name":"Helse S\u00f8r-\u00d8st RHF","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100006095","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100010745","name":"Norske Legeforening","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100010745","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Muscle and Nerve"],"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction\/Aims<\/jats:title>\n                    <jats:p>High quality reference limits for nerve conduction studies (NCS) are essential for diagnosis of neuromuscular disorders. Examining healthy controls to calculate reference limits directly is expensive and time consuming. Indirect methods, including extrapolated norms (E\u2010norms), extrapolated reference values (E\u2010Ref), and multivariate extrapolated reference values (MeRef), use historical hospital data instead. These methods sort the historical measurements in increasing order, creating so\u2010called S\u2010curves, and select normal measurements based on the shape of these S\u2010curves. Current versions of these methods have several limitations, and we aimed to improve them by modifying how they select normal measurements.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>E\u2010norms, E\u2010Ref, and MeRef were modified with new S\u2010curve selection algorithms. The modified versions of the methods were used to calculate reference limits for common NCS measurements from a large historical database. The results were compared to reference limits calculated from 680 healthy subjects using Youden's J statistic and z\u2010score deviation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The modified methods provided reference limits with Youden's J\u2009&gt;\u20090.8 and\n                      <jats:italic>z<\/jats:italic>\n                      \u2010score deviation &lt;\u20090.9 for most types of NCS measurements and similar or higher Youden's J than the unmodified methods. In most cases, the methods required at least 500 measurements and fewer than 20% abnormal measurements for good performance.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>Changing the S\u2010curve selection algorithms improves E\u2010norms, E\u2010Ref, and MeRef. The modifications require a sufficient number and proportion of normal measurements in the historical database. When these prerequisites are met, a combination of indirect methods can be used when developing reference limits from historical patient data.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/mus.70281","type":"journal-article","created":{"date-parts":[[2026,5,20]],"date-time":"2026-05-20T03:20:08Z","timestamp":1779247208000},"page":"328-338","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Improving Indirect Methods for Calculating Reference Limits for Nerve Conduction Studies From Historical Data"],"prefix":"10.1002","volume":"74","author":[{"ORCID":"https:\/\/orcid.org\/0009-0007-3500-6954","authenticated-orcid":false,"given":"Tomasz Szymon","family":"Szczepanski","sequence":"first","affiliation":[{"name":"Section for Clinical Neurophysiology, Department of Neurology Oslo University Hospital  Oslo Norway"},{"name":"Faculty of Medicine University of Oslo  Oslo Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4492-2387","authenticated-orcid":false,"given":"Kristian Bernhard","family":"Nilsen","sequence":"additional","affiliation":[{"name":"Section for Clinical Neurophysiology, Department of Neurology Oslo University Hospital  Oslo Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1280-7656","authenticated-orcid":false,"given":"\u00d8ystein","family":"Dunker","sequence":"additional","affiliation":[{"name":"Section for Clinical Neurophysiology, Department of Neurology Oslo University Hospital  Oslo Norway"},{"name":"Faculty of Medicine University of Oslo  Oslo Norway"},{"name":"Department of Research and Innovation, Division of Clinical Neuroscience Oslo University Hospital  Oslo Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew Henry","family":"Reiner","sequence":"additional","affiliation":[{"name":"Oslo Centre for Biostatistics and Epidemiology Oslo University Hospital  Oslo Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Trond","family":"Sand","sequence":"additional","affiliation":[{"name":"Department of Neurology and Clinical Neurophysiology St. Olavs Hospital  Trondheim Norway"},{"name":"Department of Neuromedicine and Movement Science, Faculty of Medicine and Health Sciences Norwegian University of Science and Technology  Trondheim Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2929-0390","authenticated-orcid":false,"given":"Martijn","family":"Tannemaat","sequence":"additional","affiliation":[{"name":"Leiden University Medical Center  Leiden the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anis","family":"Yazidi","sequence":"additional","affiliation":[{"name":"Oslo Metropolitan University  Oslo Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kerstin","family":"Bach","sequence":"additional","affiliation":[{"name":"Department of Computer Science Norwegian University of Science and Technology  Trondheim Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John Anker","family":"Zwart","sequence":"additional","affiliation":[{"name":"Faculty of Medicine University of Oslo  Oslo Norway"},{"name":"Department of Research and Innovation, Division of Clinical Neuroscience Oslo University Hospital  Oslo Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joe","family":"Jabre","sequence":"additional","affiliation":[{"name":"Department of Public Health and Community Medicine Tufts University School of Medicine  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1160-6230","authenticated-orcid":false,"given":"Petter Moe","family":"Omland","sequence":"additional","affiliation":[{"name":"Department of Neurology and Clinical Neurophysiology St. Olavs Hospital  Trondheim Norway"},{"name":"Department of Neuromedicine and Movement Science, Faculty of Medicine and Health Sciences Norwegian University of Science and Technology  Trondheim Norway"},{"name":"Department of Radiology and Nuclear Medicine St. Olavs Hospital, Trondheim University Hospital  Trondheim Norway"},{"name":"NorHEAD\u2014Norwegian Centre for Headache Research NTNU  Trondheim Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,5,19]]},"reference":[{"key":"e_1_2_13_2_1","volume-title":"Defining, Establishing, and Verifying Reference Intervals in the Clinical Laboratory: Approved Guideline","author":"Horowitz G. 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