Diagnostic Accuracy of Screening Tests for Diabetic Peripheral Neuropathy: An Umbrella Review

Peripheral neuropathy is a common cause of morbidity in diabetes. Despite recent advancements in early diagnosis methods, there is a need for practical, highly sensitive, and cost-effective screening methods in clinical practice. This study summarizes evidence from systematic reviews and meta-analys...

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Main Authors: María Mogilevskaya, Mariana Gaviria-Carrillo, John Edwin Feliciano-Alfonso, Ana M. Barragan, Carlos A. Calderon-Ospina, Mauricio O. Nava-Mesa
Format: Article
Language:English
Published: Wiley 2024-01-01
Series:Journal of Diabetes Research
Online Access:http://dx.doi.org/10.1155/jdr/5902036
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author María Mogilevskaya
Mariana Gaviria-Carrillo
John Edwin Feliciano-Alfonso
Ana M. Barragan
Carlos A. Calderon-Ospina
Mauricio O. Nava-Mesa
author_facet María Mogilevskaya
Mariana Gaviria-Carrillo
John Edwin Feliciano-Alfonso
Ana M. Barragan
Carlos A. Calderon-Ospina
Mauricio O. Nava-Mesa
author_sort María Mogilevskaya
collection DOAJ
description Peripheral neuropathy is a common cause of morbidity in diabetes. Despite recent advancements in early diagnosis methods, there is a need for practical, highly sensitive, and cost-effective screening methods in clinical practice. This study summarizes evidence from systematic reviews and meta-analyses on the diagnostic accuracy of validated screening methods for diabetic peripheral neuropathy. Two independent reviewers assessed methodological quality and bias using AMSTAR and ROBIS tools. Seven reviews with 19,531 participants were included. The monofilament test showed inconsistent sensitivity (S: 0.53–0.93) and specificity (Sp: 0.64–1.00), along with high variability in its application. Neuropad exhibited high S (86%, 95% CI 79–91). However, variations in the interpretation of results across the included studies may have impacted its Sp (65%, 95% CI 51–76). The Ipswich touch test exhibited adequate diagnostic accuracy (S: 0.77, Sp: 0.96, DOR: 75.24) but lacked comparison with gold standard tests. In vibration perception studies, the biothesiometer outperformed the tuning fork (S: 0.61–0.80 vs. 0.10–0.46). In general, heterogeneity was observed due to varied reference tests, thresholds, and patient differences. The development of automated analysis methods, as well as determination of predictive value of the combination of screening tools, is needed for further studies. Based on the study results, we suggest that clinicians should select screening tools tailored to their patient population, clinical setting, and available resources, as no single test can be universally recommended for all clinical scenarios.
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spelling doaj-art-62d838601d28459ebcb49e5d8fbc38d62024-12-12T00:00:05ZengWileyJournal of Diabetes Research2314-67532024-01-01202410.1155/jdr/5902036Diagnostic Accuracy of Screening Tests for Diabetic Peripheral Neuropathy: An Umbrella ReviewMaría Mogilevskaya0Mariana Gaviria-Carrillo1John Edwin Feliciano-Alfonso2Ana M. Barragan3Carlos A. Calderon-Ospina4Mauricio O. Nava-Mesa5Neuroscience Research Group (NeURos)Neuroscience Research Group (NeURos)Internal Medicine DepartmentPublic Health Research GroupSchool of Medicine and Health SciencesNeuroscience Research Group (NeURos)Peripheral neuropathy is a common cause of morbidity in diabetes. Despite recent advancements in early diagnosis methods, there is a need for practical, highly sensitive, and cost-effective screening methods in clinical practice. This study summarizes evidence from systematic reviews and meta-analyses on the diagnostic accuracy of validated screening methods for diabetic peripheral neuropathy. Two independent reviewers assessed methodological quality and bias using AMSTAR and ROBIS tools. Seven reviews with 19,531 participants were included. The monofilament test showed inconsistent sensitivity (S: 0.53–0.93) and specificity (Sp: 0.64–1.00), along with high variability in its application. Neuropad exhibited high S (86%, 95% CI 79–91). However, variations in the interpretation of results across the included studies may have impacted its Sp (65%, 95% CI 51–76). The Ipswich touch test exhibited adequate diagnostic accuracy (S: 0.77, Sp: 0.96, DOR: 75.24) but lacked comparison with gold standard tests. In vibration perception studies, the biothesiometer outperformed the tuning fork (S: 0.61–0.80 vs. 0.10–0.46). In general, heterogeneity was observed due to varied reference tests, thresholds, and patient differences. The development of automated analysis methods, as well as determination of predictive value of the combination of screening tools, is needed for further studies. Based on the study results, we suggest that clinicians should select screening tools tailored to their patient population, clinical setting, and available resources, as no single test can be universally recommended for all clinical scenarios.http://dx.doi.org/10.1155/jdr/5902036
spellingShingle María Mogilevskaya
Mariana Gaviria-Carrillo
John Edwin Feliciano-Alfonso
Ana M. Barragan
Carlos A. Calderon-Ospina
Mauricio O. Nava-Mesa
Diagnostic Accuracy of Screening Tests for Diabetic Peripheral Neuropathy: An Umbrella Review
Journal of Diabetes Research
title Diagnostic Accuracy of Screening Tests for Diabetic Peripheral Neuropathy: An Umbrella Review
title_full Diagnostic Accuracy of Screening Tests for Diabetic Peripheral Neuropathy: An Umbrella Review
title_fullStr Diagnostic Accuracy of Screening Tests for Diabetic Peripheral Neuropathy: An Umbrella Review
title_full_unstemmed Diagnostic Accuracy of Screening Tests for Diabetic Peripheral Neuropathy: An Umbrella Review
title_short Diagnostic Accuracy of Screening Tests for Diabetic Peripheral Neuropathy: An Umbrella Review
title_sort diagnostic accuracy of screening tests for diabetic peripheral neuropathy an umbrella review
url http://dx.doi.org/10.1155/jdr/5902036
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