{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,17]],"date-time":"2026-05-17T05:06:45Z","timestamp":1778994405831,"version":"3.51.4"},"reference-count":28,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,5,11]],"date-time":"2026-05-11T00:00:00Z","timestamp":1778457600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["J Child Neurol"],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Diagnosing juvenile myasthenia gravis (JMG) can be challenging because of limited access to confirmatory tests.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>This study evaluates the validity of bedside tests (the ice pack test, fatigability test, and combined bedside test) for diagnosing JMG in patients with ptosis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A retrospective analysis of children, aged 1 month to 18 years, diagnosed with ptosis who underwent bedside evaluation. We used sensitivity, specificity, accuracy, positive predictive value, negative predictive value, and statistical analyses to compare the diagnostic performance to that of standard confirmatory tests.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Of the 43 identified ptosis patients, 32 were included. The combined bedside test had a sensitivity of 92.8% and accuracy of 87.5% but modest specificity (50%). It outperformed the ice pack test (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009=\u2009.0005), which showed low sensitivity (42.8%) and accuracy (43.8%). The fatigability test had 82% sensitivity and 92% PPV.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The combined bedside test is a dependable screening instrument for JMG and may facilitate early diagnosis. The fatigability test is also a useful addition.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/08830738261446215","type":"journal-article","created":{"date-parts":[[2026,5,12]],"date-time":"2026-05-12T04:22:16Z","timestamp":1778559736000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Diagnostic Accuracy of the Combined Bedside Tests (Icepack and Fatigability) in Diagnosing Juvenile Myasthenia Gravis"],"prefix":"10.1177","author":[{"given":"Pechpailin","family":"Kortnoi","sequence":"first","affiliation":[{"name":"Chulalongkorn University"},{"name":"Department of Pediatrics, King Chulalongkorn Memorial Hospital, Bangkok, Thailand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jakkrit","family":"Amornvit","sequence":"additional","affiliation":[{"name":"Chulalongkorn University"},{"name":"Department of Neurology, King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, Thailand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2854-4029","authenticated-orcid":false,"given":"Tanitnun","family":"Paprad","sequence":"additional","affiliation":[{"name":"Chulalongkorn University"},{"name":"Department of Pediatrics, King Chulalongkorn Memorial Hospital, Bangkok, Thailand"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2026,5,11]]},"reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.3389\/fneur.2020.00743"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1055\/s-0033-1364181"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1212\/CON.0000000000001161"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1002\/mus.25214"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1002\/mus.21195"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.3389\/fneur.2023.1119294"},{"issue":"1","key":"e_1_3_2_8_2","article-title":"Ice test for ocular myasthenia gravis","volume":"84","author":"Lertchavanakul A","year":"2001","unstructured":"Lertchavanakul A, Gamnerdsiri P, Hirunwiwatkul P. Ice test for ocular myasthenia gravis. J Med Assoc Thai. 2001;84(Suppl 1):S131-S136.","journal-title":"J Med Assoc Thai"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1002\/mus.26319"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00415-022-10986-3"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0177078"},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.1093\/qjmed\/hcy284"},{"key":"e_1_3_2_13_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0161-6420(00)00458-9"},{"key":"e_1_3_2_14_2","doi-asserted-by":"publisher","DOI":"10.1080\/08820538.2023.2194984"},{"key":"e_1_3_2_15_2","doi-asserted-by":"publisher","DOI":"10.1111\/cen3.12774"},{"key":"e_1_3_2_16_2","doi-asserted-by":"publisher","DOI":"10.1159\/000212372"},{"key":"e_1_3_2_17_2","doi-asserted-by":"publisher","DOI":"10.1002\/mus.25374"},{"key":"e_1_3_2_18_2","volume-title":"Electromyography and Neuromuscular Disorders. 4th ed","author":"David C","year":"2022","unstructured":"David C, Preston BES. Electromyography and Neuromuscular Disorders. 4th ed. Elsevier; 2022."},{"key":"e_1_3_2_19_2","doi-asserted-by":"publisher","DOI":"10.1097\/BOR.0000000000000647"},{"key":"e_1_3_2_20_2","first-page":"81","volume-title":"How to Calculate an Adequate Sample Size? How to Practice Academic Medicine and Publish from Developing Countries? A Practical Guide","author":"Sapra RL","year":"2022","unstructured":"Sapra RL. How to Calculate an Adequate Sample Size? How to Practice Academic Medicine and Publish from Developing Countries? A Practical Guide. Springer Nature Singapore; 2022:81-93."},{"key":"e_1_3_2_21_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00417-014-2759-3"},{"key":"e_1_3_2_22_2","doi-asserted-by":"publisher","DOI":"10.2307\/2529310"},{"key":"e_1_3_2_23_2","doi-asserted-by":"publisher","DOI":"10.4103\/ijo.IJO_2015_21"},{"key":"e_1_3_2_24_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.nmd.2018.12.011"},{"key":"e_1_3_2_25_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.pediatrneurol.2018.06.007"},{"key":"e_1_3_2_26_2","doi-asserted-by":"publisher","DOI":"10.1002\/mus.23857"},{"key":"e_1_3_2_27_2","doi-asserted-by":"publisher","DOI":"10.1097\/CND.0b013e31821c5634"},{"key":"e_1_3_2_28_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ncl.2018.01.010"},{"issue":"9","key":"e_1_3_2_29_2","first-page":"385","article-title":"[Validation of the ice pack test in ophthalmoparesis due to myasthenia gravis]","volume":"57","author":"Ramirez-Antunez AG","year":"2013","unstructured":"Ramirez-Antunez AG, Garcia-Ramos G, Estanol-Vidal B, Juarez-Flores A. [Validation of the ice pack test in ophthalmoparesis due to myasthenia gravis]. Rev Neurol. 2013;57(9):385-395.","journal-title":"Rev Neurol"}],"container-title":["Journal of Child Neurology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/08830738261446215","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/08830738261446215","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/08830738261446215","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,17]],"date-time":"2026-05-17T04:22:19Z","timestamp":1778991739000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/08830738261446215"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5,11]]},"references-count":28,"alternative-id":["10.1177\/08830738261446215"],"URL":"https:\/\/doi.org\/10.1177\/08830738261446215","relation":{},"ISSN":["0883-0738","1708-8283"],"issn-type":[{"value":"0883-0738","type":"print"},{"value":"1708-8283","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,5,11]]},"article-number":"08830738261446215"}}