Turkish version of the Michigan Neuropathy Screening Instrument in the assessment of diabetic peripheral neuropathy: a validity and reliability study.

Abstract

Diabetic peripheral neuropathy (DPN) is the most common complication of diabetes mellitus (DM). The Michigan Neuropathy Screening Instrument (MNSI) is a simple, brief, and useful screening tool that was designed to assess DPN. The aim of this study was to develop a Turkish version of the MNSI and assess its reliability and validity. Eighty-three patients with DM who were divided into two groups according the results of nerve conduction studies (NCS) as having DPN or without DPN were enrolled in this cross-sectional study. The Toronto clinical scoring system, pain detect questionnaire, and NCS were assessed along with the MNSI. Each section of the MNSI was internally consistent (Cronbach's alpha > 0.70), and the scores of both sections were positively correlated with total MNSI score (r = 0.938; r = 0.908, respectively, p < 0.001). The test-retest reliability of the Turkish version of the MNSI was determined as 0.99 for the total score (intraclass correlation coefficient = 0.996). Using the agreement between MNSI scores and DPN diagnosis by NCS as a gold standard, receiver-operating characteristic (ROC) curve values for section A and section B were estimated as 0.973 and 1.00, respectively. When a cut-off value ≥ 3.0 in section A and a cut-off value ≥ 2.0 in section B were used, we obtained a sensitivity of 97.6% and 100%; a specificity of 63.4% and 97.6%; a positive predictive value of 72.7% and 97.6%; and a negative predictive value of 96.3% and 100%, respectively. The Turkish version of MNSI is a reliable and valid tool for screening DPN in Turkish patients.