Diagnostic accuracy of bedside neurological examinations compared to biothesiometry for peripheral neuropathy: a community-based cross-sectional study
DOI:
https://doi.org/10.31117/neuroscirn.v8i4.443Keywords:
Peripheral neuropathy, Biothesiometer, Screening tool, Vibration, MalaysiaAbstract
Peripheral neuropathy is a common but frequently underdiagnosed condition, especially in community settings. The diagnostic performance of four simple screening tests (vibration perception, temperature sensation, ankle reflex, and pinprick sensation) was examined against the biothesiometer as the reference standard for detecting peripheral neuropathy. This was a cross-sectional study conducted on those aged ≥18 years who visited retail pharmacies in Malaysia (March 2021 - May 2022). Four clinical examination tests, including the biothesiometer, were used to detect peripheral neuropathy. Sensitivity, specificity, positive predictive value (PPV) and negative predictive value were computed in SPSS. The prevalence of peripheral neuropathy was 22.7% among 1,283 participants. Sensitivity was highest for ankle reflex (34.12%), followed by vibration testing (31.76%), pinprick (24.41%) and temperature sensation (6.76%). The specificity of all the tests was high (95.02 – 97.78%). The PPV was highest for vibration testing (83.72%). In non-clinical settings with limited time and equipment, vibration testing, together with ankle reflex, may serve as a reliable screening tool, given its high PPV and specificity. Given its low cost and ease of use, community health policy should consider early use of vibration and ankle tests to screen for peripheral neuropathy among at-risk groups, particularly among patients with diabetes and those over 50 years old.
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Copyright (c) 2025 Siew Mooi Ching, Huan Li, Abdul Hanif Khan Yusof Khan, Navin Kumar Devaraj, Ai Theng Cheong, Sajesh Veettil, Xian Hui Teh, Yong Jian Leong, Fan Kee Hoo, Wan Aliaa Wan Sulaiman, Wei Chao Loh, Mansi Patil, Yuh-Fen Pung, Vasudevan Ramachandran
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