Global Cost and Availability of Neuro-Diagnostic Tests: A Survey-Based Analysis (S37.004)
Bibliographic record
Abstract
Objective: To assess the global availability and cost of five neuro-diagnostic tests (CT, EEG, EMG, MRI, and lumbar puncture) to better characterize challenges in the diagnosis of neurologic diseases in resource-limited settings. Background: While the global distribution of neurologists and access to therapeutic options has been examined, less is known about access to neuro-diagnostic tests. Methods: We designed a 40-question survey assessing the availability and cost of CT, EEG, EMG, MRI, and LP. We then distributed the survey electronically to neurologists using a global listserv. Results: A total of 54 responses were received from 32 unique countries; 22[percnt] (7/32) of respondents were from low-income countries (LICs), 19[percnt] (6/32) from lower-middle income countries (LMICs), 34[percnt] (11/32) from upper-middle income countries (UMICs), and 25[percnt] (8/32) from high-income countries (HICs). The availability of tests in LICs, LMICs, UMICs, and HICs (respectively) were: 71[percnt], 80[percnt], 91[percnt], 100[percnt] for EEG; 71[percnt], 100[percnt], 100[percnt], 100[percnt] for CT; 57[percnt], 67[percnt], 82[percnt], and 88[percnt] for MRI; and 71[percnt], 80[percnt], 91[percnt], 100[percnt] for EMG. The average costs of diagnostic tests in LIC, LMIC, UMIC, and HIC (respectively) were: US$21.76, US$15.00, US$12.95, US$18.86 for EEG; US$89.03, US$72.27, US$18.13, US$36.19 for CT; US$206.14, US$87.22, US$108.27, US$176.61 for MRI; US$31.46, US$37.50, US$72.32, US$27.17 for EMG; US$12.10, US$13.40, US$34.88, US$32.63 for LP. The tests most often listed as “necessary but not available” were EEG and CSF analysis in LICs, and EEG and genetic testing in LMICs. Conclusion: Access to neuro-diagnostic tests is limited in LICs and LMICs; cost is often a significant barrier. With improved access to diagnostics, care for patients with neurologic diseases can be improved and access to therapeutics optimized. Improving the availability of neuro-diagnostic tests is important in both the evaluation and treatment of individual patients, and it is essential in order to characterize the global epidemiology of neurologic diseases.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.004 | 0.011 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.003 | 0.006 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.006 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".