title: Two-stage community-based screening model for estimating prevalence of diabetic polyneuropathy (KCIS no. 6).
abstract: The aim of this study was to apply a calibrated two-stage community-based design to estimate the prevalence of diabetic distal sensorimotor polyneuropathy (DPN) in Taiwan. Type 2 diabetics were identified from a population-based screening program in Keelung, Taiwan. Administration of the Neurological Symptom Score (NSS) questionnaire identified 210 DPN-positive cases of the 587 diabetic subjects tested. The accuracy of this NSS screening was tested with sensitive electrophysiological DPN diagnosis. A smaller validation study was also conducted to estimate the sensitivity and specificity of the NSS questionnaire. In the validation study, the overall prevalence rate for DPN among type 2 diabetics was 26.79%. The sensitivity, specificity, positive predictive value and negative predictive values were 73.33, 30.49, 24.72 and 75.76%, respectively. The estimates of sensitivity, specificity and positive predictive values were 75.00, 33.33 and 42.86% for old cases of diabetes, and 72.22, 29.69 and 22.41% for newly diagnosed cases. The range of prevalence rate in the main study was adjusted to 28.46-36.30% after calibration for sensitivity and specificity with the validation study data. A two-stage community-based screening model with calibration of prevalence rate was developed and enabled a cost-effective DPN prevalence rate estimate in a study with a large number of subjects.
authors.affiliation: Department of Neurology, Shin-Kong WHS Memorial Hospital, Taipei, Taiwan.
authors.forename: Wei-Chih
authors.initials: WC
authors.lastname: Hsu
authors.forename: Yueh-Hsia
authors.initials: YH
authors.lastname: Chiu
authors.forename: Hou-Chang
authors.initials: HC
authors.lastname: Chiu
authors.forename: Horng-Huei
authors.initials: HH
authors.lastname: Liou
authors.forename: Ya-Chung
authors.initials: YC
authors.lastname: Jeng
authors.forename: Tony Hsiu-Hsi
authors.initials: TH
authors.lastname: Chen
mesh_terms: D000368:Aged; D003929:Diabetic Neuropathies / Q000175:diagnosis / Q000453:epidemiology*; D005260:Female; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000379:methods*; D008475:Median Nerve / Q000503:physiopathology; D008875:Middle Aged; D009431:Neural Conduction / Q000502:physiology; D015995:Prevalence; D015203:Reproducibility of Results; D012584:Sciatic Nerve / Q000503:physiopathology; D012680:Sensitivity and Specificity; D011795:Surveys and Questionnaires; D013624:Taiwan / Q000453:epidemiology; D014459:Ulnar Nerve / Q000503:physiopathology