Software for cerebrospinal fluid diagnostics and statistics

Hansotto Reiber

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Background: In CSF analysis for diagnostics we have knowledge-based software for numerical and graphical data interpretation, but software programs for statistics are scarce. Free, stand-alone software programs that calculate all individual functions of CSF protein analysis and allow the statistical treatment of groups of diseases numerically and graphically are presented for relevant examples. 

Methods: Diagnosis of an intrathecal synthesis refers to the upper limit of the reference range, Qlim = Qmean +3SD, but statistical evaluation of its frequency is referred to Qmean+2SD. When quantifying intrathecal synthesis for statistics, either the absolute amount (IgGloc) or the relative intrathecal fraction (IgGIF) can be reported with reference to the mean reference curve, Qmean. The free software “CSF research Tool” for immunoglobulins allows diagnostic and statistic evaluations with Reibergrams and calculation of mean values and standard deviations from disease groups. The software “FLC-K statistics” for free light chains Kappa offers for diagnostics and statistics the numerical and graphical interpretation basis for statistical processing in exported Excel tables. A free “CSF-App” for Smartphones provides data calculation for diagnostics of single patients with examples of disease-related data patterns.

Results: Patients with clinically isolated syndrome (CIS) who were later diagnosed as MS showed no immunological differences to patients initially diagnosed as MS (same mean quantity of intrathecal synthesis in CIS and MS detectable for IgG and FLC-K). The frequently claimed diagnostically higher sensitivity of the FLCK analysis compared to IgG, can be explained by the up to 3-fold higher mean intrathecal fraction of FLC-K, corresponding to a higher frequency in the detection of intrathecal synthesis with FLCK analysis.

Conclusions: With a knowledge-based quantification in CSF analysis, supported by knowledgebased software programs, scientifically and diagnostically important results can be obtained.

Palabras clave

Cerebrospinal fluid; Statistics; Software; CSF-App; Clinically Isolated Syndrome; Multiple Sclerosis; IgG; Free light chains Kappa


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