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Table 2 Symptoms/diagnoses observed at a frequency > 10% in the ALS cohort* compared with the Medicare cohort

From: Diagnosis pathway for patients with amyotrophic lateral sclerosis: retrospective analysis of the US Medicare longitudinal claims database

Symptom group Symptom/diagnosis Pre-ALS frequency, %* Medicare frequency, % Prevalence ratio
Bulbar Speech disturbance 24 2 15
Bulbar Voice resonance disorder 15 1 11
Limb Muscle weakness (generalized) 30 5 5.9
Limb Lack of coordination 13 3 4
Bulbar Dysphagia§ 27 7 3.9
Nerve Hereditary and idiopathic peripheral neuropathies§ 35 10 3.7
Nerve Cervicalgia 18 5 3.7
Limb Gait abnormality/difficulty walking 32 11 2.8
Other Transient cerebral ischemia 13 5 2.8
Other Loss of weight 17 6 2.7
Other Stroke 11 4 2.4
Other Lumbago/backache§ 52 27 1.9
Other Malaise and fatigue 56 32 1.8
Other Syncope and collapse 26 14 1.8
Limb Pain in limb 44 27 1.6
Other Esophageal reflux 31 21 1.5
Other Constipation 15 10 1.5
Respiratory Pulmonary collapse/failure 17 12 1.4
Other Dizziness and giddiness 12 8 1.4
Other Swelling in limb 11 8 1.4
Respiratory Respiratory difficulties§ 62 49 1.3
Other Hypothyroidism 27 22 1.3
Other Nausea, vomiting, etc. 11 9 1.3
Limb Pain in joint 31 26 1.2
Respiratory Bronchitis 18 14 1.2
Respiratory Chronic airway obstruction 19 17 1.1
Respiratory Acute upper respiratory infection 12 11 1.1
  1. ALS, amyotrophic lateral sclerosis.
  2. *Frequency > 10% in the eight quarters before diagnosis of ALS (not including the quarter of diagnosis).
  3. Prevalence in the Medicare cohort.
  4. Percentage of patients in the ALS cohort having a given symptom/the percentage of patients in the Medicare cohort with the same symptom.
  5. §Includes multiple symptom types.