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Diabetology & Metabolic Syndrome

Open Access

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)

  • Lisiane Stefani Dias1Email author,
  • Otto Henrique Nienov1,
  • Maria Cândida Ribeiro Parisi1 and
  • Helena Schmid1
Diabetology & Metabolic Syndrome20157(Suppl 1):A199

Published: 11 November 2015


Public HealthGoldDepressive SymptomPhysical ExaminationNeuropathy


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).


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.


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.


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.

Authors’ Affiliations

Universidade Federal do Rio Grande Do Sul, Porto Alegre, Brazil


© Dias et al. 2015

This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. The Creative Commons Public Domain Dedication waiver ( applies to the data made available in this article, unless otherwise stated.