Clinical evaluation of the consistency between two diagnostic criteria for diabetic peripheral neuropathy / 南方医科大学学报

<p><b>OBJECTIVE</b>To evaluate the consistency between the clinical diagnostic criteria and the ascertained diagnostic criteria for diabetic peripheral neuropathy (DPN) in the Preventive and Treatment Guidelines of Diabetes in China (2013) and explore an economic, convenient, and accurate approach to DPN diagnosis.</p><p><b>METHODS</b>The patients with type 2 diabetes admitted in our department from April to June, 2014 were examined for nerve conduction velocity, 10 g nylon silk, vibration threshold value, sense of temperature and pain, and ankle reflex. The sensitivity, specificity, positive predictive value, negative predictive value, Youden index, and Kappa value were calculated to assess the diagnostic power of the two diagnostic criteria.</p><p><b>RESULTS</b>Of the 151 patients enrolled, 106 (70.2%) had a diagnosis of DPN consistent with the ascertained diagnostic criteria, as compared to 86 (56.95%) who were diagnosed according to the clinical diagnostic criteria; the latter patients accounted for 81.13% of former cases. The sensitivity, specificity, positive predictive value, negative predictive value, Youden index, and Kappa value of the clinical diagnostic criteria were 80.19%, 97.78%, 98.84%, 67.69%, 77.97%, and 0.69, respectively, which were highly consistent with those of the ascertained diagnostic criteria; the sensitivity to compression showed a poor consistency between the two diagnostic criteria. In the 5 screening tests, the combined test of temperature sensation, vibration perception, and ankle reflex showed the highest AUC value among their different combinations.</p><p><b>CONCLUSION</b>The clinical diagnostic criteria for DPN show good consistency with the ascertained diagnostic criteria, and for patients with clinical symptoms or with only one positive sign, combination of the two diagnostic criteria can achieve the maximum diagnostic power.</p>

The performance evaluation of the five inspection methods in the diagnosis of peripheral neuropathy in diabetes / 西安交通大学学报(医学版)

Objective To evaluate the diagnostic value of the 10 g nylon silk,vibration threshold value,sense of temperature,pain sense and ankle reflex in the diagnosis of diabetic peripheral neuropathy (DPN)and to search an exact diagnostic method of DPN not only economical but also easy to handle.Methods To carry out the measurements of the NCV,10 g nylon silk,vibration threshold value,sense of temperature,pain sense and ankle reflex on the patients who have been diagnosed with diabetes (DM)between April 2014 and June 2014 in the endocrinology department of our hospital.The sensitivity,specificity,positive forecast value,negative forecast value,Youden index and K value serve as assessments of the diagnostic efficiency of clinically diagnostic criteria. Results The sensitivity,specificity,positive forecast value,negative forecast value,Youden index and K value of the ankle reflex are 66.04%,95.56%,97.22%,54.43%,61.60%,and 0.5 1 in mediate accordance with the diagnostic criteria and it is the best one among the five methods.While the sensitivity and accordance of the pressure sense are of the least accordance with the diagnostic criteria.The correspondent value of the combination of vibration threshold sense,temperature sense and ankle reflex are respectively 86.79%,91.11%,95.83%,74.55%, 77.90% and 0.73,in positive accordance with the diagnostic criteria.Conclusion Among the five methods the consistency between the combination of vibration threshold sense,temperature sense and ankle reflect and diagnostic criteria is of positive accordance and can be applied in screening DPN clinically.