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dc.contributor.authorDunker, Øystein
dc.contributor.authorUglem, Martin
dc.contributor.authorKvaløy, Marie Bu
dc.contributor.authorLøseth, Sissel
dc.contributor.authorHjelland, Ina Elen
dc.contributor.authorAllen, Sara Maria
dc.contributor.authorVigeland, Maria Dehli
dc.contributor.authorKleggetveit, Inge Petter
dc.contributor.authorSand, Trond Halfdan
dc.contributor.authorNilsen, Kristian Bernhard
dc.date.accessioned2023-12-20T12:59:18Z
dc.date.available2023-12-20T12:59:18Z
dc.date.issued2023-11-20
dc.description.abstractIntroduction There is a need for simple and cheap diagnostic tools for diabetic polyneuropathy (DPN). We aimed to assess the diagnostic accuracy of the 5.07/10 g monofilament test in patients referred to polyneuropathy assessments, as well as to examine how disease severity, age, sex and neuropathic pain (NP) impact diagnostic accuracy.<p> <p>Research design and methods Five Norwegian university hospitals recruited patients with diabetes aged 18–70 referred to neurological outpatient clinics for polyneuropathy assessments. The 5.07/10 g SemmesWeinstein monofilament examination (SWME) was validated against the Toronto consensus for diagnosing diabetic neuropathies; the results were stratified by age, sex and NP. Disease severity was graded by a combined nerve conduction study (NCS) Z-score, and logistic regression was applied to assess whether disease severity was a predictor of diagnostic accuracy. <p>Results In total, 506 patients were included in the study. Global sensitivity was 0.60 (95% CI 0.55, 0.66), specificity 0.82 (95% CI 0.75, 0.87), positive and negative predictive values were 0.86 (95% CI 0.81, 0.90) and 0.52 (95% CI 0.46, 0.58), respectively, positive and negative likelihood ratios were 3.28 (95% CI 2.37, 4.53) and 0.49 (95% CI 0.42, 0.57), respectively. The SWME was less sensitive in females (0.43), had lower specificity in patients with NP (0.56), and performed worse in patients ≥50 years. NCS-based disease severity did not affect diagnostic accuracy (OR 1.15, 95% CI 0.95, 1.40). <p>Conclusions This multicenter study demonstrates poor diagnostic performance for the 5.07/10 g SWME in patients with diabetes referred to polyneuropathy assessments; it is particularly unsuited for female patients and those with NP. The diagnostic accuracy of the SWME was not influenced by NCS-based disease severity, demonstrating that it does not perform better in patients with later stages of DPN. We do not recommend the use of the 5.07/10 g monofilament in the evaluation of patients with diabetes referred to polyneuropathy assessments.en_US
dc.identifier.citationDunker, Uglem, Kvaløy, Løseth, Hjelland, Allen, Vigeland, Kleggetveit, Sand, Nilsen. Diagnostic accuracy of the 5.07 monofilament test for diabetes polyneuropathy: influence of age, sex, neuropathic pain and neuropathy severity. BMJ Open Diabetes Research & Care. 2023en_US
dc.identifier.cristinIDFRIDAID 2202992
dc.identifier.doi10.1136/bmjdrc-2023-003545
dc.identifier.issn2052-4897
dc.identifier.urihttps://hdl.handle.net/10037/32182
dc.language.isoengen_US
dc.publisherBMJen_US
dc.relation.journalBMJ Open Diabetes Research & Care
dc.rights.accessRightsopenAccessen_US
dc.rights.holderCopyright 2023 The Author(s)en_US
dc.rights.urihttps://creativecommons.org/licenses/by/4.0en_US
dc.rightsAttribution 4.0 International (CC BY 4.0)en_US
dc.titleDiagnostic accuracy of the 5.07 monofilament test for diabetes polyneuropathy: influence of age, sex, neuropathic pain and neuropathy severityen_US
dc.type.versionpublishedVersionen_US
dc.typeJournal articleen_US
dc.typeTidsskriftartikkelen_US
dc.typePeer revieweden_US


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Attribution 4.0 International (CC BY 4.0)
Med mindre det står noe annet, er denne innførselens lisens beskrevet som Attribution 4.0 International (CC BY 4.0)