Table 1.
Diagnostic methods for DPN.
| Author(s) | Diagnostic method | Sensitivity | Specificity | PPV | NPV |
|---|---|---|---|---|---|
| Single tests | |||||
| Dyck et al. [116] | Abnormal ankle reflex | 60.3 | 90.5 | ||
| Abnormal VPT | 17.2 | 96.4 | |||
|
| |||||
| Al-Geffari [117] | Abnormal ankle reflex | 51.4 | 97.7 | 94.9 | 71.0 |
| 10 g SW Monofilament | 69.7 | 87.9 | 82.6 | 78.0 | |
| 128-Hz tuning fork | 72.5 | 88.7 | 84.0 | 79.7 | |
|
| |||||
| Composite scores | |||||
| Dyck et al. [116] | NIS (LL) + 7 tests | 100 | 100 | ||
| NIS (LL) | 69 | 86.9 | |||
|
| |||||
| Feldman et al. [118] | MNSI > 2 | 80 | 90 | 97 | 74 |
|
| |||||
| Moghtaderi et al. [114] | MNSI > 1.5 | 79 | 65 | 59 | 83 |
| MNSI > 2.0 | 65 | 83 | 71 | 79 | |
| MNSI > 2.5 | 50 | 91 | 77 | 74 | |
| MNSI > 3.0 | 35 | 94 | 80 | 70 | |
|
| |||||
| Xiong et al. [119] | NSC | 85.96 | 77.03 | 74.24 | 87.69 |
| NIS | 59.65 | 98.65 | 97.14 | 76.04 | |
| MNSI > 1.0 | 70.18 | 81.08 | 74.07 | 77.92 | |
| MNSI > 1.5 | 57.89 | 97.30 | 94.29 | 75.00 | |
| MNSI > 2.0 | 49.12 | 97.30 | 93.33 | 71.29 | |
| MNSI > 2.5 | 36.84 | 98.65 | 95.45 | 66.97 | |
|
| |||||
| Al-Geffari [117] | Combined tuning fork & SW Monofilament | 89.5 | 84.9 | 92.8 | 89.5 |
|
| |||||
| Liu et al. [120] | TCSS | 77.2 | 75.6 | ||
|
| |||||
| Nerve conduction studies | |||||
| Dyck et al. [116] | ≥1 nerve w/abnormal NCS | 93.1 | 57.7 | ||
| ≥2 nerves w/abnormal NCS | 81 | 91.2 | |||
| ≥3 nerves w/abnormal NCS | 51.7 | 97.8 | |||
DM, diabetes mellitus; IDDM, insulin-dependent diabetes mellitus; NIDDM, non-insulin-dependent diabetes mellitus; IGT, impaired glucose tolerance; MNSI, Michigan Neuropathy Screening.
Instrument; NCS, Nerve Conduction Study; NIS (LL), neuropathic impairment (disability) score of lower limbs; NSC, nerve symptomatic change score; SW, Semmes-Weinstein.