title: Agreement between clinical screening procedures for neuropathy in the feet.
abstract: BACKGROUND
  The correlation between monofilament testing, symptom surveys, and electrodiagnostic studies for the diagnosis of axonal polyneuropathy has not been well studied. This investigation was done to assess the agreement between these procedures in a non-random sample of volunteers.
  
  
  METHODS
  The procedures evaluated included electrodiagnostic tests of the sural nerve, monofilament testing of the great toe, a symptom survey, and a body diagram. Kappa coefficients and sensitivity and specificity, using nerve conduction as a "gold standard," were used to determine the agreement between various combinations of procedures.
  
  
  RESULTS
  Poor agreement (kappa values -0.12-0.44) and sensitivity (sensitivity <30%) were found for all combinations of symptoms and monofilament results in comparison with sural peak latency and amplitude.
  
  
  CONCLUSIONS
  Overall, the results demonstrated a low discriminatory power for the screening procedures for identifying persons with impaired sural nerve function. The results highlight the need for further development and evaluation of screening methods for distal neuropathy in population-based studies.
authors.affiliation: Department of Environmental Health Sciences, School of Public Health, University of Michigan, M1835 SPH I, 1415 Washington Heights, Ann Arbor, Michigan 48109-2029, USA.
authors.forename: Yi
authors.initials: Y
authors.lastname: Wang
authors.forename: Jaclyn M
authors.initials: JM
authors.lastname: Goodrich
authors.forename: Robert
authors.initials: R
authors.lastname: Werner
authors.forename: Brenda
authors.initials: B
authors.lastname: Gillespie
authors.forename: Niladri
authors.initials: N
authors.lastname: Basu
authors.forename: Alfred
authors.initials: A
authors.lastname: Franzblau
mesh_terms: D003920:Diabetes Mellitus / Q000473:pathology / Q000503:physiopathology; D004558:Electric Stimulation / Q000379:methods; D004568:Electrodiagnosis / Q000379:methods*; D005260:Female; D005528:Foot / Q000503:physiopathology*; D006801:Humans; D008297:Male; D009431:Neural Conduction / Q000502:physiology*; D011115:Polyneuropathies / Q000175:diagnosis*; D011930:Reaction Time; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D013497:Sural Nerve / Q000503:physiopathology; D011795:Surveys and Questionnaires