Comparison study of different scoring systems on screening peripheral neuropathy of diabetic patients / 中国综合临床

ABSTRACT

Objective To evaluate the effectiveness of the Michigan neuropathy screening instrument (MNSI),the Michigan Diabetic Neuropathy Score(MDNS) and the Toronto Clinical Scoring System(TCSS) in screening diabetic peripheral neuropathy (DPN) in order to find a rapid,simple and accurate way for DPN screening.Methods Three hundred and twenty-seven type 2 diabetic patients were enrolled in the study.All patients received the 4 simple tests including MNSI,MDNS,TCSS and neural electrophysiological test (NET).Taking the results of NET as the golden criteria,the sensitivity,specificity,positive and negative predictive values,accuracy,Youden indexes and Kappa values of the scoring systems were analyzed to evaluate their clinical effectiveness.Results Compared with NET examination,sensitivity,specificity and accuracy of MDNS were 90.5％ (162/179),68.92％ (102/148),80.73％ (264/327),and 87.71％ (157/179),78.38％ (116/148),83.49％ (273/327) for MNSI and 79.33％ (142/179),65.54％ (97/148),73.09％ (239/327) for TCSS.MNSI and MDNS were better than TCSS in terms of effectiveness of DPN diagnosis and consistence with the result of NET (MDNS0.6 045 ; MNSI0.6 648 ; TCSS0.4524).The area under the ROC curve of MNSI,MDNS and TCSS were 0.757,0.719,0.667.Conclusion Among the three scales methods,MNSI is a better method in screening DPN for its simplicity and reliability.