Sensitivity and specificity of neuropathy diabetes score, neuropathy symptoms score, diabetic neuropathy score and esthesiometry compared with the gold standards Michigan neuropathy screening instrument (MNSI) and Beck depression inventory (BDI)

Background

In a previous study, we observed that the Results of an organized questionnaire to assess the presence of diabetic neuropathy (Diabetic Neuropathy Symptoms-DNS) were associated with the presence of scores of depressive symptoms (BDI ≥10).

Objective

To evaluate how different scores for the presence of symptoms/signs of neuropathy (Neuropathy Diabetes Score-NDS; Neuropathy Symptoms Score-NSS; DNS and esthesiometry) had sensitivity and specificity, compared to the gold standard score of Michigan (MNSI) (≥2,5) and the gold standard score of Beck depressive symptoms (BDI).

Materials and methods

207 patients with Diabetes type 2 were evaluated with MNSI, BDI, NDS, esthesiometry, NSS and DNS.

Results

Questionnaires used to define the presence of polyneuropathy have a similar sensitivity for the detection of symptoms of depression (70 to 80%), while the physical examination for the presence of polyneuropathy (NDS) and esthesiometry has a sensitivity of ±50% and specificity of ±85% compared to MNSI and a sensitivity of ±23% and specificity of ±85% when compared to BDI (Figure 1). The symptom questionnaires have sensitivity and specificity of±75% and±35%, respectively, for both MNSI and BDI.

Figure 1

Sensitivity and specificty of NDS, esthesiometry NSS and DNS, compared to MNSI and BDI.

Conclusions

We suggest not to use only questionnaires to define the presence of neuropathy in diabetic patients-in daily practice, physical examination (MNSI or NDS) must be used.