Diagnostic performance of graded tuning fork vibration thresholds as a stand-alone test and within clinical assessments of diabetic neuropathy
Authors' conclusion
The new VST reference data shall enable clinicians to detect DSPN with higher accuracy in clinical practice, particularly when combined with a single small fibre test.
Study context
- Population
- Individuals with type 1 or type 2 diabetes and individuals with normal glucose tolerance; diagnostic performance assessed in 373 individuals with diabetes who underwent skin biopsies for intraepidermal nerve fibre density (IENFD)373 with biopsy
- Comparison
- Age-dependent Vibration Sensation Thresholds (VST) alone vs VST combined with PinPrick test for confirmed DSPN
- Outcome
- Diagnostic performance in detecting confirmed small or large fibre DSPN according to Toronto consensus criteria
Performance
As reported in the abstract
Diagnosis of confirmed DSPN
| Test or model | Sensitivity | Specificity | Accuracy |
|---|---|---|---|
| VST | 73.5% | 85.4% | 82.3% |
| VST + PinPrick | 83.4% | 80.3% | 81.2% |
Sensitivity
VST73.5%
VST + PinPrick83.4%
Specificity
VST85.4%
VST + PinPrick80.3%
Accuracy
VST82.3%
VST + PinPrick81.2%
Further findings
- Neuropathy Disability Score (NDS) incorporating VST was associated with nerve conduction indices, Quantitative Sensory Tests (QST) and IENFD
Original publication
Diagnostic performance of graded tuning fork vibration thresholds as a stand-alone test and within clinical assessments of diabetic neuropathy. Diabetes Res Clin Pract. Published 8 May 2025. doi:10.
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