Evaluating the Usefulness of the Diabetic Peripheral Neuropathy Screening Process

Aims: To evaluate the clinical utility of the diabetic peripheral neuropathy (DPN) screening process in the diagnosis of DPN among diabetic patients. Methods: A total of 816 diabetic patients performed nerve conduction velocity (NCV), Somatosensory evoked potential (SEP), Toronto clinical scoring system (TCSS), and DPN screening process at baseline. The NCV and SEP were used as the 'gold standard' against which the sensitivity, specificity, positive predictive value, negative predictive value and Youden's index of the TCSS and the DPN screening process determined by the Chinese Diabetes Society of the Chinese Medical Association in 2010. Results: According to the DPN screening process, 602 patients (73.77%) were positive while 458 patients (56.13%) were positive according to the TCSS score. The sensitivity, specificity, positive predictive value, negative predictive value, and Youden's index of DPN screening process were 89.49%, 66.56%, 81.99%, 78.82%, and 0.5605, respectively. Patients with DPN exhibited numbness (46.02%), pain (15.71%), paresthesia (16.59%), pinprick sensation (12.17%), and others (10.62%). The sensitivity and specificity of the various DPN checks were as follows: pressure sensation (19.44% and 95.62%), vibration perception (77.78% and 60.87%), temperature sensation (35.19% and 89.13%), and pinprick (31.48% and 84.78%). The sensitivity, specificity, positive predictive value, negative predictive value, and Youden's index of a TCSS score >= 6 were 78.21%, 84.11%, 89.33%, 69.40%, and 0.6232, respectively. DPN screening process took an average of 5.89 minutes, while TCSS spent an average of 10.32 minutes. Conclusion: DPN screening process is economical, simple, fast, accurate, and could be used for early clinical screening of DPN in patients with diabetes.