Reliability of the neurological scores for assessment of sensorimotor neuropathy in type 2 diabetics.
OBJECTIVE
To check the reliability of the commonly used neurological scoring systems taking the nerve conduction studies as the reference.


METHODS
Diagnosed diabetics (n=60) were selected by purposive sampi ng Detection and grading of neuropathy were done according to Diabetic Neuropathy Symptom Score (DrNS), modified Neuropathy Symptom Score (NSS), Diabetic Neuropathy Examination (DNE) and modified Neuropathy Disability Score (NDS). For the nerve conduction studies, amplitudes, velocities and latencies of minimum two (Sural, Peroneal) and maximum six, i.e., three sensory (Sural, Ulnar, Median) and three motor (Peroneal, Ulnar, Tibial) nerves were checked. If the patient had 2 or more than two abnormal findings in any of the nerve he was labeled to have peripheral sensorimotor neuropathy. Later the sensitivity, specificity and diagnostic efficacy of each neurological score was checked taking nerve conduction studies as the gold standard.


RESULTS
Taking the NCS as gold standard DNS, DNE, NSS and NDS had 64.1%, 17.95%, 82.05%, 92.31% sensitivity and 80.95%, 100%, 66.67%, 47.62% specificity, respectively. Diagnostic efficacy of DNS was 70%, DNE was 47%, NSS was 77% and NDS was 77%.


CONCLUSIONS
Combining different scores gives better sensitivity and specificity. NDS is the most reliable neurological test for detecting and grading DPN.
Army Medical College/NUST, Pakistan.
Ambreen
A
Asad
Muhammad Amjad
MA
Hameed
Umar Ali
UA
Khan
Nadeem
N
Ahmed
Mujeeb-ur-Rahman Abid
MU
Butt
D000328:Adult; D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000503:physiopathology*; D003929:Diabetic Neuropathies / Q000175:diagnosis* / Q000503:physiopathology; D018450:Disease Progression; D005260:Female; D006305:Health Status Indicators; D006801:Humans; D008297:Male; D008875:Middle Aged; D009431:Neural Conduction; D009460:Neurologic Examination; D011237:Predictive Value of Tests; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D011795:Surveys and Questionnaires