Outpatient Clinic of Obesity, Diabetes and Metabolism in the Second Department of Internal Medicine, Democritus University of Thrace, Alexandroupolis, Greece.
Diabetes Care. 2011 Jun;34(6):1378-82. doi: 10.2337/dc10-2205. Epub 2011 Apr 19.
To estimate the accuracy of Neuropad for the diagnosis and staging of distal symmetric polyneuropathy (DPN) across different stages of neuropathy, using multiple-level likelihood ratios (LRs) to interpret the time necessary to complete the color change of the test.
We conducted a cross-sectional, cohort-type diagnostic accuracy study in 251 consecutive adult type 2 diabetic patients with no peripheral arterial disease or other potential causes of neuropathy, who were recruited between January 2005 and December 2008 from the diabetes outpatient clinics in Alexandroupolis Hospital, Greece. Patients were tested for DPN by means of the neuropathy disability score (NDS) and Neuropad. Multiple-level LRs for time to complete color change were calculated across different stages of neuropathy.
The areas under the curve for the diagnosis of any (NDS of ≥3), at least moderate (NDS of ≥6), or severe (NDS of ≥9) DPN were 0.91, 0.96, and 0.97, respectively. The calculation of multiple-level LRs showed that time to complete color change <360 s suggested the absence of neuropathy. Values between 360 and 1,000 s were indicative of mild neuropathy. Finally, values between 1,000 and 1,200 or >1,200 s were strongly suggestive of moderate or severe DPN, respectively.
Neuropad could be used as a triage test for the diagnosis and staging of DPN in patients with type 2 diabetes, prompting referral to specialized care setting.
通过多水平似然比（LR）来解释完成测试颜色变化所需的时间，评估 Neuropad 在不同神经病变阶段对远端对称性多发性神经病（DPN）的诊断和分期的准确性。
我们在希腊亚历山德鲁波利斯医院的糖尿病门诊，进行了一项横断面、队列型诊断准确性研究，共纳入了 251 例连续的成年 2 型糖尿病患者，他们无周围动脉疾病或其他潜在的神经病变原因。使用神经病残疾评分（NDS）和 Neuropad 对患者进行 DPN 检测。针对不同阶段的神经病变，计算完成颜色变化的多水平 LR。
任何（NDS≥3）、至少中度（NDS≥6）或严重（NDS≥9）DPN 的诊断曲线下面积分别为 0.91、0.96 和 0.97。多水平 LR 的计算表明，颜色变化时间<360 秒提示无神经病变。360-1000 秒之间的值提示轻度神经病变。最后，1000-1200 秒或>1200 秒之间的值分别强烈提示中度或重度 DPN。
Neuropad 可作为 2 型糖尿病患者 DPN 的诊断和分期的筛选测试，提示转诊至专科治疗环境。
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