Dataset Information

Grading the loss of sensation in diabetic patients: A psychometric evaluation of the rotterdam diabetic foot study test battery.

ABSTRACT:

Introduction

Static- and moving 2-point discrimination (S2PD, M2PD), 10-g monofilaments- and tuning fork are validated outcome measures of clinical manifestations of diabetes-related neuropathy. No modern statistical techniques have been used to investigate how well these instruments combine to measure sensory loss.

Methods

To grade sensory loss at the feet, we fitted parametric forms of Item Response Theory models to the data of these instruments.

Results

The fit statistics indicate that the loss of sensation is gradable, with readily available instruments. S2PD and M2PD are lost first, followed by vibration sense, the 10-g monofilament and the ability to feel a cold stimulus.

Conclusions

This test battery appears to provide sound measurement properties in a group of diabetic patients with diverse amounts of sensory loss. This approach may be used in clinical practice to grade sensory loss reliably and quickly, with instruments that are easy to use. Muscle Nerve 58: 559-565, 2018.

SUBMITTER: Rinkel WD

PROVIDER: S-EPMC6646912 | biostudies-literature | 2018 Oct

REPOSITORIES: biostudies-literature

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Publications

Grading the loss of sensation in diabetic patients: A psychometric evaluation of the rotterdam diabetic foot study test battery.

Rinkel Willem D WD Rizopoulos Dimitris D Aziz M Hosein MH Van Neck Johan W JW Cabezas Manuel Castro MC Coert J Henk JH

Muscle & nerve 20180822 4

<h4>Introduction</h4>Static- and moving 2-point discrimination (S2PD, M2PD), 10-g monofilaments- and tuning fork are validated outcome measures of clinical manifestations of diabetes-related neuropathy. No modern statistical techniques have been used to investigate how well these instruments combine to measure sensory loss.<h4>Methods</h4>To grade sensory loss at the feet, we fitted parametric forms of Item Response Theory models to the data of these instruments.<h4>Results</h4>The fit statistic ...[more]

PMID: 30028522

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Project description:Research Question: Previous cross-sectional studies have shown an association between sudomotor dysfunction and diabetic foot ulceration (DFU). The aim of this prospective multicenter study was to determine the role of dryness of foot skin and of established neurological modalities in the prediction of risk for foot ulceration in a cohort of individuals with diabetes mellitus (DM). Design: The study was conducted from 2012 to 2017. A total of 308 subjects with DM without history of DFU or critical limb ischemia completed the study. Diabetic neuropathy was assessed using the neuropathy symptom score (NSS) and neuropathy disability score (NDS). In a subset of participants, vibration perception threshold (VPT) was evaluated. Dryness of foot skin was assessed by the visual indicator plaster method (IPM). The diagnostic performance of the above neurological modalities for prediction of DFU was tested by receiver operating characteristic curve (ROC) analysis. Results: During the 6-year follow-up, 55 patients (annual ulceration incidence 2.97%) developed DFU. Multivariate Cox-regression analysis after controlling for the effect of age, gender, and DM duration demonstrated that the risk (hazard ratio, 95% confidence intervals) of DFU increased significantly with either abnormal IPM (3.319, 1.460-7.545, p = 0.004) or high (≥6) NDS (2.782, 1.546-5.007, p = 0.001) or high (≥25 volts) VPT (2.587, 1.277-5.242, p = 0.008). ROC analysis showed that all neurological modalities could discriminate participants who developed DFU (p < 0.001). IPM testing showed high sensitivity (0.86) and low specificity (0.49), while high vs. low NDS and VPT showed low sensitivity (0.40 and 0.39, respectively) and high specificity (0.87 and 0.89, respectively) for identification of patients at risk for DFU. Conclusion: Dryness of foot skin assessed by the IPM predicts the development of DFU. IPM testing has high sensitivity, whereas high NDS and VPT have high specificity in identifying subjects at risk for DFU. The IPM can be included in the screening methods for identification of the foot at risk.

Dataset Information

Grading the loss of sensation in diabetic patients: A psychometric evaluation of the rotterdam diabetic foot study test battery.

Introduction

Methods

Results

Conclusions

Publications

Grading the loss of sensation in diabetic patients: A psychometric evaluation of the rotterdam diabetic foot study test battery.

Similar Datasets

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