{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T12:51:22Z","timestamp":1791204682078,"version":"4.2.0"},"reference-count":47,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2025,4,4]],"date-time":"2025-04-04T00:00:00Z","timestamp":1743724800000},"content-version":"vor","delay-in-days":3,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,4,1]],"date-time":"2025-04-01T00:00:00Z","timestamp":1743465600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100001659","name":"Deutsche Forschungsgemeinschaft","doi-asserted-by":"publisher","award":["577631"],"award-info":[{"award-number":["577631"]}],"id":[{"id":"10.13039\/501100001659","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Euro J of Neurology"],"published-print":{"date-parts":[[2025,4]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Over the past years, some studies in amyotrophic lateral sclerosis (ALS) have provided heterogeneous findings regarding demographic and clinical data as well as the impact of various prognostic factors. It is well known that these inconsistencies might be caused by a selection bias in hospital\u2010based data sets. In this study, we sought to further characterize this selection bias.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      We compared hospital\u2010based data from the ALS center at Ulm University (UC;\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20093833; 1997\u20132021) with the population\u2010based ALS registry Swabia (SR;\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009852; 2010\u20132020).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Patients from UC were younger (age of onset 60.9 [IQR 52.4\u201368.9] vs. 65.0 [57.0\u201372.7]), had a higher share of males (60.5% vs. 56.3%), a longer diagnostic delay (10.5 [IQR 6.4\u201318.4] months vs. 6.9 [IQR 3.4\u201312.1] months), a higher prevalence of the \u201cdefinite\u201d category according to El Escorial diagnostic criteria (60.9% vs. 11.2%), a higher share of familial cases (12.9% vs. 6.3%), a slower progression rate (points of ALS functional rating scale revised lost per month \u22120.54 [IQR \u22121.02 to \u22120.28] vs. \u22120.79 [IQR \u22121.47 to \u22120.43]), and (among all deceased patients) a higher share of percutaneous endoscopic gastrostomy (26.7% vs. 17.7%) and non\u2010invasive ventilation (34.3% vs. 25.3%).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The observed differences likely indicate a selection bias in hospital\u2010based data, which may be attributed, among others, to the willingness to travel large distances to a specialized center, the desire to participate in clinical studies, and the attitude toward life\u2010prolonging measures. These differences must be considered when interpreting and generalizing study results from hospital\u2010based populations.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/ene.70137","type":"journal-article","created":{"date-parts":[[2025,4,5]],"date-time":"2025-04-05T11:07:34Z","timestamp":1743851254000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Population\u2010Based Versus Hospital\u2010Based Data in Amyotrophic Lateral Sclerosis\u2014A Factor to Consider?"],"prefix":"10.1111","volume":"32","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6352-0909","authenticated-orcid":false,"given":"Johannes","family":"Dorst","sequence":"first","affiliation":[{"name":"Department of Neurology University of Ulm  Ulm Germany"},{"name":"German Center for Neurodegenerative Diseases (DZNE)  Ulm 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