Diagnostic accuracy of the 5.07 monofilament test for diabetes polyneuropathy: influence of age, sex, neuropathic pain and neuropathy severity
Authors' conclusion
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.
Study context
- Population
- Patients with diabetes aged 18–70 referred to neurological outpatient clinics for polyneuropathy assessments, 5 Norwegian university hospitals
- Participants
- 506 patients
- Comparison
- 5.07/10 g Semmes-Weinstein monofilament examination (SWME) vs Toronto consensus diagnosis of diabetic polyneuropathy (DPN)
- Outcome
- Diagnostic accuracy of the 5.07/10 g monofilament test for DPN
Methodological detailsmulticentre
- Multicentre
Performance
As reported in the abstract
- Global sensitivity
- 0.60 (95% CI 0.55, 0.66)
- Specificity
- 0.82 (95% CI 0.75, 0.87)
- PPV
- 0.86 (95% CI 0.81, 0.90)
- NPV
- 0.52 (95% CI 0.46, 0.58)
- Positive likelihood ratio
- 3.28 (95% CI 2.37, 4.53)
- Negative likelihood ratio
- 0.49 (95% CI 0.42, 0.57)
Further findings
Accuracy by sex, neuropathic pain (NP) and age
- Sensitivity in females (lower)
- 0.43
- Specificity in patients with NP (lower)
- 0.56
- Performed worse in patients ≥50 years
Nerve conduction study (NCS)-based disease severity as predictor of diagnostic accuracy
- Disease severity did not affect diagnostic accuracy, OR
- 1.15 (95% CI 0.95, 1.40)
Original publication
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