Clinical Efficacy of Diagnostic Approach of Diabetic Neuropathy in Korean NIDDM(Preliminary report): with Feldman's Approach to Diabetic Neuropathy.
- Author:
Young Goo SHIN
1
;
Yoon Jung OH
;
Young Yoon KO
;
Seong Keun LEE
;
Seong Kyu LEE
;
Yoon Sok JUNG
;
Kawn Woo LEE
;
Hyeon Man KIM
Author Information
1. Department of Endocrinology & Metabolism, Ajou University School of Medicine, Suwon, Korea.
- Publication Type:Original Article
- Keywords:
Diabetic neuropathy;
Diagnosis
- MeSH:
Diabetes Mellitus, Type 2;
Diabetic Neuropathies*;
Diagnosis;
Humans;
Mass Screening;
Sensitivity and Specificity;
Surveys and Questionnaires
- From:Korean Journal of Medicine
1998;54(6):765-769
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
OBJECTIVES: It is important to consider the symptoms of diabetic neuropathy in determining a diagnostic approach. To evaluate diabetic neuropathy, an appropriate questionnaire for Korean diabetic patients is required. In 1994, Feldman et al. proposed the two-step diagnostic approach which included a questionnaire. To adapt a diagnostic approach and questionnaire for Korean diabetics, we initially diagnosed diabetic neuropathy by using Feldman's method and by assessing the efficiency of their method for Korean diabetics as a preliminary study. METHODS: We diagnosed diabetic neuropathy with Feldman's method in 99 NIDDM patients who visited Ajou university hospital from October 1, 1996 to April 30, 1997. The sensitivity and specificity of Feldman's 4 diagnostic procedures were ebaluated. To include the highly specific symptoms in the diagnostic approach, we applied a different scoring system(from 5 to 1) to the questionnaire accroding to specificity and then evaluated the sensitivity and specificity with this new system. If the sensitivity and specificity were 60% or more, the new scoring system was regarded as clinically useful. RESULTS: Using Feldman's method, the sensitivity of MNSIQ and MNSIC was 12.8% and the specificity was 88.3% and 98.3%, respectively. The sensitivity of MDNS and NCV was 100% and the specificity was 68.3% and 61.6%, respectively. The new scoring system consisted of 13 of 15 questions with sensitivity of 46.2% and specificity of 71.7%, omitting 2 questions due to possible relation to vascular symptoms. Among the 4 diagnostic procedures, the strongest correlation existed between MDNS and NCV. None of the procedures had a significant correlatiion with MNSIQ. MNSIC, which shares similar characteristics with MDNS, had significant correlation with MDNS and NCV, but its sensitivity was very low. CONCLUSON: MNSIQ and MNSIC were not useful as screening instruments in the diagnostic approach to diabetic neuropathy using Feldman's method. Thus, a new questionnaire composed of symptoms common in Korean diabetic patients should be designed, and MNSIC could be omitted from the diagnostic approach.
