Signs and symptoms versus nerve conduction studies to diagnose diabetic sensorimotor polyneuropathy: Cl vs. NPhys trial.

Muscle & Nerve
Peter J DyckAdrian Vella

Abstract

The purpose was to test whether physicians can validly and reproducibly diagnose diabetic sensorimotor polyneuropathy (DSPN). Twelve physicians assessed 24 patients with diabetes mellitus (DM) on consecutive days (576 examinations) with physical features and voice disguised. Results were compared to gold standard 75% group diagnosis (dx) and a nerve conduction score (Sigma5 NC nds). Masking of patients was achieved. Reproducibility measured by the kappa coefficient and compared to Sigma5 NC nd varied considerably among physicians: median and ranges: signs 0.8 (0.32-1.0); symptoms 0.79 (0.36-1.0), and diagnoses 0.47 (0.33-0.84), both low and high scores indicating poor performance. There was substantial agreement between 75% group dx and confirmed NC abnormality (abn). As compared to Sigma5 NC, individual physicians' clinical dx was excessively variable and frequently inaccurate. Study physician dx from signs and symptoms were excessively variable, often overestimating DSPN. Specific approaches to improving clinical proficiency should be tested.

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Citations

Jun 15, 2011·Current Diabetes Reports·Dinesh SelvarajahSolomon Tesfaye
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Oct 9, 2012·Muscle & Nerve·Brian CallaghanLynda Lisabeth
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Jul 19, 2013·Muscle & Nerve·Peter J DyckUNKNOWN Clinical vs. Neurophysiology Trial 3 Investigators
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Nov 22, 2013·Muscle & Nerve·Hua PanJun Kimura
Aug 10, 2013·Muscle & Nerve·Peter J DyckUNKNOWN members of the Cl versus NPhys Trials
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May 6, 2016·Australasian Physical & Engineering Sciences in Medicine·Yunxia HuangJiaan Zhu

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