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

Abstract

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: Seventy-two consecutive patients with diabetes mellitus underwent a full neurological examination and 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.

Conclusion: 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.