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Multi-Site Testing With a Point-of-Care Nerve Conduction Device Can Be Used in an Algorithm to Diagnose Diabetic Sensorimotor Polyneuropathy

¹ Division of Endocrinology, University Health Network, University of Toronto, Toronto, Ontario, Canada
² Division of Neurology, University Health Network, University of Toronto, Toronto, Ontario, Canada

Address correspondence and reprint requests to Bruce A. Perkins, 200 Elizabeth St., EN-12-217, Toronto, Ontario M5G 2C4, Canada. E-mail: bruce.perkins{at}uhn.on.ca

OBJECTIVE—We aimed to establish whether multi-nerve testing with a point-of-care nerve conduction device could be used to diagnose diabetic sensorimotor polyneuropathy.

RESEARCH DESIGN AND METHODS—A total of 72 consecutive patients with diabetes underwent a full neurological examination and a concurrent evaluation for nine standard electrophysiological parameters using conventional nerve conduction studies (the reference standard) and a point-of-care device.

RESULTS—Spearman coefficients for correlation of point-of-care and conventional parameters ranged between 0.76 and 0.91 (P < 0.001 in all comparisons). Agreement by the method of Bland and Altman was acceptable despite small systematic biases. Fifty subjects (69%) had neuropathy according to conventional criteria. The sensitivity and specificity for the point-of-care device to identify such neuropathy was 88 and 82%, respectively.

CONCLUSIONS—A novel point-of-care device has reasonable diagnostic accuracy and thus may represent a sufficiently accurate alternative for detecting the diffuse electrophysiological criteria necessary to make the diagnosis of diabetic sensorimotor polyneuropathy.

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