Predicting respiratory failure in amyotrophic lateral sclerosis: still a long way to go

Amyotrophic lateral sclerosis (ALS) is a relentlessly progressive neurodegenerative disease that affects the brain and spinal cord motor neurons leading to progressive muscle weakness, irreversible disability, respiratory failure and death within a time range of a few months to more than 10 years [1]. Although use of noninvasive ventilation (NIV) is standard of care in ALS and improves health-related quality of life and survival [2, 3], no accurate model to predict respiratory failure in ALS was available until the recently published work by Ackrivo et al . [4]. The authors should therefore be congratulated for this much awaited contribution to this field. Recently published model to predict respiratory failure in ALS may not perform well across different populations and in single individuals <http://bit.ly/2XbI6Me>