Evaluation of the four simple methods in the diagnosis of diabetic peripheral neuropathy

Abstract

To evaluate the efficacy of neuropathy symptom score/neuropathy disability score (NSS/NDS), Michigan Neuropathy Screening Instrument (MNSI), vibration perception threshold (VPT) and 24010 g monofilament examination in the diagnosis of diabetic peripheral neuropathy (DPN). 240 patients with type 2 diabetes underwent the 4 simple tests: NSS/NDS, MNSI, VPT, and 10 g monofilament examination and nerve conduction velocity (NCV) examination. Using the results of NCV as golden criteria, the sensitivity, specificity, positive and negative predictive values, accuracy and kappa values of these tests were analyzed. The sensitivity, specificity, accuracy, and kappa value of MNSI score over 2 were 78.15%, 88.43%, 83.33%, and 0.67 respectively. The validity could be ranked in the following order with respect to the diagnosis of DPN: MNSI > VPT > NSS/NDS > 10 g monofilament examination. MNSI is a rapid, simple and reliable test for screening DPN in both diabetes clinics and epidemiological surveys.