Journal of Southern Medical University ›› 2015, Vol. 35 ›› Issue (07): 1039-.

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Clinical evaluation of the consistency between two diagnostic criteria for diabetic peripheral neuropathy

  

  • Online:2015-07-20 Published:2015-07-20

Abstract: Objective 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. Methods 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. Results 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. Conclusion 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.