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McIllhatton A, Lanting S, Lambkin D, et al. Reliability of recommended non-invasive chairside screening tests for diabetes-related peripheral neuropathy: a systematic review with meta-analyses. BMJ Open Diabetes Res Care. 2021;9(2)doi: 10.1136/bmjdrc-2021-002528.
McIllhatton, A., Lanting, S., Lambkin, D., Leigh, L., Casey, S., & Chuter, V. (2021). Reliability of recommended non-invasive chairside screening tests for diabetes-related peripheral neuropathy: a systematic review with meta-analyses. BMJ open diabetes research & care, 9(2), . https://doi.org/10.1136/bmjdrc-2021-002528
McIllhatton, Ally, et al. "Reliability of recommended non-invasive chairside screening tests for diabetes-related peripheral neuropathy: a systematic review with meta-analyses." BMJ open diabetes research & care vol. 9,2 (2021). doi: https://doi.org/10.1136/bmjdrc-2021-002528
McIllhatton A, Lanting S, Lambkin D, Leigh L, Casey S, Chuter V. Reliability of recommended non-invasive chairside screening tests for diabetes-related peripheral neuropathy: a systematic review with meta-analyses. BMJ Open Diabetes Res Care. 2021 Dec;9(2). doi: 10.1136/bmjdrc-2021-002528. PMID: 34952841.
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BMJ Open Diabetes Res Care. 2021 Dec;9(2). doi: 10.1136/bmjdrc-2021-002528.

Reliability of recommended non-invasive chairside screening tests for diabetes-related peripheral neuropathy: a systematic review with meta-analyses.

BMJ open diabetes research & care

Ally McIllhatton, Sean Lanting, David Lambkin, Lucy Leigh, Sarah Casey, Vivienne Chuter

Affiliations

  1. Discipline of Podiatry, The University of Newcastle Faculty of Health and Medicine, Ourimbah, New South Wales, Australia.
  2. Discipline of Podiatry, The University of Newcastle Faculty of Health and Medicine, Ourimbah, New South Wales, Australia [email protected].
  3. Hunter Medical Research Institute, The University of Newcastle, New Lambton, New South Wales, Australia.

PMID: 34952841 DOI: 10.1136/bmjdrc-2021-002528

Abstract

The objective is to determine, by systematic review, the reliability of testing methods for diagnosis of diabetes-related peripheral neuropathy (DPN) as recommended by the most recent guidelines from the International Diabetes Foundation, International Working Group on the Diabetic Foot and American Diabetes Association. Electronic searches of Cochrane Library, EBSCO Megafile Ultimate and EMBASE were performed to May 2021. Articles were included if they reported on the reliability of recommended chairside tests in diabetes cohorts. Quality appraisal was performed using a Quality Appraisal of Reliability Studies checklist and where possible, meta-analyses, with reliability reported as estimated Cohen's kappa (95% CI). Seventeen studies were eligible for inclusion. Pooled analysis found acceptable inter-rater reliability of vibration perception threshold (VPT) (κ=0.61 (0.50 to 0.73)) and ankle reflex testing (κ=0.60 (0.55 to 0.64)), but weak inter-rater reliability for pinprick (κ=0.45 (0.22 to 0.69)) and 128 Hz tuning fork (κ=0.42 (0.15 to 0.70)), though intra-rater reliability of the 128 Hz tuning fork was moderate (κ=0.54 (0.37 to 0.73)). Inter-rater reliability of the four-site monofilament was acceptable (κ=0.61 (0.45 to 0.77)). These results support the clinical use of VPT, ankle reflexes and four-site monofilament for screening and ongoing monitoring of DPN as recommended by the latest guidelines. The reliability of temperature perception, pinprick, proprioception, three-site monofilament and Ipswich touch test when performed in people with diabetes remains unclear.

© Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.

Keywords: diabetic foot; neuropathy

Conflict of interest statement

Competing interests: None declared.

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