OBJECTIVES: The accurate and early diagnosis of amyotrophic lateral sclerosis 
(ALS) is important for extending the life expectancy of patients. However, 
previous studies that have assessed the diagnostic sensitivities of the Awaji 
criteria (AC) and the revised El Escorial criteria (rEEC) in patients with ALS 
have been inconsistent, most of them were consensual regarding the advantage of 
Awaji over conventional criteria. Our study sought to compare the roles of AC 
and rEEC in the diagnosis of ALS.
METHODS: Data from a total of 294 consecutive patients with ALS were collected 
between January 2014 and August 2015 in the Peking Union Medical College 
Hospital. The clinical and electrophysiological records of 247 patients were 
eventually analyzed. The primary outcome measures were the sensitivities of the 
AC and rEEC for the diagnosis of ALS.
RESULTS: The sensitivity of probable or definite ALS as diagnosed with the AC 
(78%) was greater than that of the rEEC (36%, P <0.001). Following the 
application of the AC, 103 of the 147 patients categorized as probable 
ALS-laboratory supported from the rEEC were upgraded to probable or definite 
ALS, and 44 were downgraded to possible ALS.
CONCLUSIONS: Our data demonstrated that the AC exhibited greater diagnostic 
sensitivity than the rEEC in a Chinese ALS population. The use of the AC should 
be considered in clinical practice.