title: [A comparison of clinical effectiveness of different neuropathy scoring systems in screening asymptomatic diabetic peripheral neuropathy].
abstract: OBJECTIVE
  To evaluate the clinical effectiveness in screening asymptomatic diabetic peripheral neuropathy (ADPN) by the Michigan neuropathy screening instrument (MNSI) and the Toronto clinical scoring system (TCSS).
  
  
  METHODS
  MNSI, TCSS and neural electrophysiological test (NET) were conducted in 232 neurologically asymptomatic type 2 diabetes patients. By using the results of NET as the golden criteria for diagnosis of ADPN, we evaluated the effectiveness of the two different scoring system by the receiver operator characteristic curve. The sensitivity, specificity, positive and negative predictive values, accuracy, Youden indexes and kappa values on different diagnostic cut-off points of MNSI and TCSS were analyzed. The correlation between the two different scoring system and the risk factors of diabetic peripheral neuropathy (DPN) were also analyzed.
  
  
  RESULTS
  The area under the ROC curve of MNSI and TCSS were 0.792, 0.704, respectively. The sensitivity, specificity, accuracy, Youden indexes and kappa values of MNSI over 2 and TCSS over 2 were 66.2%vs 73.3%, 90.4% vs 63.7%, 78.3% vs 68.5%, 0.566 vs 0.370, and 0.588 vs 0.345, respectively. MNSI was better than TCSS in the effectiveness of diagnosing ADPN and consistence with the result of NET. Moreover, MNSI was associated with the most related risk factors of DPN including age, glycosylated hemoglobin (HbA1c), HbA1c × disease duration, islet function and HDL-C.
  
  
  CONCLUSIONS
  MNSI could be used as a relatively simple and reliable method for clinical and epidemiological screening and assessment of ADPN.
authors.affiliation: Department of Endocrinology, School of Medicine of Zhejiang University, Hangzhou, China.
authors.forename: Hong
authors.initials: H
authors.lastname: Hu
authors.forename: Hong
authors.initials: H
authors.lastname: Li
authors.forename: Fen-ping
authors.initials: FP
authors.lastname: Zheng
authors.forename: Yi
authors.initials: Y
authors.lastname: Cheng
authors.forename: Jing
authors.initials: J
authors.lastname: Miao
authors.forename: Wei
authors.initials: W
authors.lastname: Zhang
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003924:Diabetes Mellitus, Type 2 / Q000150:complications; D003929:Diabetic Neuropathies / Q000175:diagnosis* / Q000503:physiopathology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009460:Neurologic Examination / Q000379:methods*; D010523:Peripheral Nervous System Diseases / Q000175:diagnosis* / Q000503:physiopathology; D011237:Predictive Value of Tests; D012372:ROC Curve; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D055815:Young Adult