Signs and symptoms versus nerve conduction studies to diagnose diabetic sensorimotor polyneuropathy: CI vs. NPhys trial

Peter J. Dyck, Carol J. Overland, Phillip A. Low, William J. Litchy, Jenny L. Davies, P. James B. Dyck, Peter C. O'Brien, James W. Albers, Henning Andersen, Charles F. Bolton, John D. England, Christopher J. Klein, J. Gareth Llewelyn, Michelle L. Mauermann, James W. Russell, Wolfgang Singer, A. Gordon Smith, Solomon Tesfaye, Adrian Vella

Research output: Contribution to journalArticle

127 Scopus citations

Abstract

The purpose was to test whether physicians can validly and reproducibly diagnose diabetic sensorimotor polyneuropathy (DSPN). Twelve physicians assessed 24 patients with diabetes mellitus (DM) on consecutive days (576 examinations) with physical features and voice disguised. Results were compared to gold standard 75% group diagnosis (dx) and a nerve conduction score (Σ5 NC nds). Masking of patients was achieved. Reproducibility measured by the kappa coefficient and compared to Σ5 NC nd varied considerably among physicians: median and ranges: signs 0.8 (0.32-1.0); symptoms 0.79 (0.36-1.0), and diagnoses 0.47 (0.33-0.84), both low and high scores indicating poor performance. There was substantial agreement between 75% group dx and confirmed NC abnormality (abn). As compared to Σ5 NC, individual physicians' clinical dx was excessively variable and frequently inaccurate. Study physician dx from signs and symptoms were excessively variable, often overestimating DSPN. Specific approaches to improving clinical proficiency should be tested.

Original languageEnglish (US)
Pages (from-to)157-164
Number of pages8
JournalMuscle and Nerve
Volume42
Issue number2
DOIs
StatePublished - Aug 2010

Keywords

  • Diabetes mellitus
  • Diabetic sensorimotor polyneuropathy
  • Nerve conduction score

ASJC Scopus subject areas

  • Physiology
  • Clinical Neurology
  • Cellular and Molecular Neuroscience
  • Physiology (medical)

Fingerprint Dive into the research topics of 'Signs and symptoms versus nerve conduction studies to diagnose diabetic sensorimotor polyneuropathy: CI vs. NPhys trial'. Together they form a unique fingerprint.

  • Cite this

    Dyck, P. J., Overland, C. J., Low, P. A., Litchy, W. J., Davies, J. L., Dyck, P. J. B., O'Brien, P. C., Albers, J. W., Andersen, H., Bolton, C. F., England, J. D., Klein, C. J., Llewelyn, J. G., Mauermann, M. L., Russell, J. W., Singer, W., Smith, A. G., Tesfaye, S., & Vella, A. (2010). Signs and symptoms versus nerve conduction studies to diagnose diabetic sensorimotor polyneuropathy: CI vs. NPhys trial. Muscle and Nerve, 42(2), 157-164. https://doi.org/10.1002/mus.21661