Diagnostic accuracy of the VibraTip in detection of diabetic peripheral neuropathy

Abstract

AimsClinical assessment of peripheral neuropathy can be performed by testing vibration sense using a tuning fork and cutaneous sensation using a 10g Monofilament. The VibraTip® is a novel device which produces a constant vibratory stimulus and therefore assesses vibration sense. This study wa evaluated the diagnostic accuracy of the VibraTip compared to the tuning fork. Methods From 100 patients with diabetes, 50 patients had confirmed peripheral neuropathy (PN +ve) and 50 were confirmed to have no peripheral neuropathy (PN -ve) as assessed by neurothesiometer. Both groups were then assessed using both the VibraTip and tuning fork. The sensitivity, specificity, predictive values and likelihood ratios for diagnosing peripheral neuropathy were calculated. Results A statistically significant difference in sensitivity (52%)(P<0.001) between the VibraTip and tuning fork results was observed for subjects +ve for peripheral neuropathy. However no statistically significant difference in specificity (6%)(P<0.25) was seen for subjects –ve for peripheral neuropathy. Conclusion This study confirms that the VibraTip is comparable to the neurothesiometer, and superior to the tuning fork, in the detection of peripheral neuropathy and could be a useful screening tool in clinical practice