Diagnostic accuracy of the VibraTip in detection of diabetic peripheral neuropathy
DOI:
https://doi.org/10.15277/bjdvd.2014.005Abstract
Aims
Clinical assessment of peripheral neuropathy can be performed by testing vibration sense using a tuning fork and cutaneous sensation using a 10g Monofilament. The VibraTip® is a novel device which produces a constant vibratory stimulus and therefore assesses vibration sense. This study wa evaluated the diagnostic accuracy of the VibraTip compared to the tuning fork.
Methods
From 100 patients with diabetes, 50 patients had confirmed peripheral neuropathy (PN +ve) and 50 were confirmed to have no peripheral neuropathy (PN -ve) as assessed by neurothesiometer. Both groups were then assessed using both the VibraTip and tuning fork. The sensitivity, specificity, predictive values and likelihood ratios for diagnosing peripheral neuropathy were calculated.
Results
A statistically significant difference in sensitivity (52%)(P<0.001) between the VibraTip and tuning fork results was observed for subjects +ve for peripheral neuropathy. However no statistically significant difference in specificity (6%)(P<0.25) was seen for subjects –ve for peripheral neuropathy.
Conclusion
This study confirms that the VibraTip is comparable to the neurothesiometer, and superior to the tuning fork, in the detection of peripheral neuropathy and could be a useful screening tool in clinical practiceReferences
Rumpf H. Uber einen Fall von Syringomyelie nebst Beitrag zur Untersuchung der Sensibilitat. Neurologisches Zentralblatt 1889.
Lewandowsky M. Handbuk der Neurologie.Bd 1. Allg. Neurologie 11. Berlin: Spinger, 1910: 499-502.
Freeman C, Okun, M S. Origin of the sensory examination in neurology. Semin Neurol 2002;22:399-407. http://dx.doi.org/10.1055/s-2002-36762
Juma A, Mandal A. Vibration sensitivity testing with tuning fork: 256 Hz or 512 Hz? European J Plastic Surgery 2007;30:5-6. http://dx.doi.org/10.1007/s00238-007-0125-y
Bottomley J. Economic costs of diabetes in the US in 2007 - Implications for Europe. Br J Diabetes & Vasc Dis 2008;8:96-100. http://dx.doi.org/10.1177/14746514080080020801
Bril V, Kolic J, Ngo M, et al. Comparison of a Neurothesiometer and Vibration in measurement of vibration perception thresholds and relationship to nerve conduction studies. Diabetes Care 1997;20:1360-2. http://dx.doi.org/10.2337/diacare.20.9.1360
www.vibratip.com (Accessed February 2014).
Levy A. Preliminary data on Vibratip, a new source of standardized vibration for bedside assessment of peripheral neuropathy. Br J Diabetes Vasc Dis 2010;10:284-6. http://dx.doi.org/10.1177/1474651410390741
Bracewell N, Game F, Jeffcoate W, Scammell BE. Clinical evaluation of a new device in the assessment of peripheral sensory neuropathy in diabetes. Diabet Med 2012;29:1553-5. http://dx.doi.org/10.1111/j.1464-5491.2012.03729.x
Bowling FL, Abbott CA, Harris WE Atanasov S, Malik RA, Boulton AJ. A pocket size device for testing the integrity of sensation in the outpatient setting. Diabet Med 2012;29:1550-2. http://dx.doi.org/10.1111/j.1464-5491.2012.03730.x
Published
Issue
Section
License
Publish & Transfer of Copyright Agreement
For the mutual benefit and protection of the Author and the Journal Owner/Publisher it is necessary that the Author provides formal written Consent to Publish and Transfer of Copyright before publication of the Work.
