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Clinical Efficacy of Diagnostic Approach of Diabetic Neuropathy in Korean NIDDM (Preliminary report) -with Feldman's Approach to Diabetic Neuropathy-

Other Title
당뇨병성 신경병증 진단법의 유용성(예비보고) -Feldman 등의 2단계 진단법에 대하여-
Authors
신, 영구; 오, 윤정; 고, 영윤; 이, 성근; 이, 성규; 정, 윤석; 이, 관우; 김, 현만
Citation
The Korean journal of medicine, 54(6):765-769, 1998
Journal Title
The Korean journal of medicine; 대한내과학회지
ISSN
1738-93642289-0769
Abstract
Objectives : It is important to consider the symptoms of diabetic neuropathy in

determining a diagnostic approach. To evaluate diabetic neuropathy, an appropriate

questionnaire for korean diabetic patients is required. In 1994, Feldman et al. proposed the two-step diagnostic approach which included a questionnaire. To adapt a diagnostic approach and questionnaire for Korean diabetics, we initially diagnosed diabetic neuropathy by using Feldman's method and by assessing the efficiency of their method for Korean diabetics as a preliminary study.

Methods : We diagnosed diabetic neuropathy with Feldman's method in 99 NIDDM

patients who visited Ajou university hospital from October 1, A996 to April 30, 1997.

The sensitivity and specificity of Feldman's 4 diagnostic procedures were evaluated. To

include the highly specific symptoms in the diagnostic approach, we applied a different

scoring system(from 5 to 1) to the questionnaire according to specificity and then evaluated the sensitivity and specificity with this new system. If the sensitivity and specificity were 60% or more, the new scoring system was regarded as clinically useful.

Results : Using Feldman's method, the sensitivity of MNSIQ and MNSIC was 12.8%

and the specificity was 88.3% and 98.3%, respectively. The sensitivity of MDNS and

NCV was 100% and the specificity was 68.3% and 61.6%, respectively. The new scoring

system consisted of 13 of 15 questions with sensitivity of 46.2% and specificity of

71.7%, omitting 2 questions due to possible relation to vascular symptoms. Among the 4

diagnostic procedures, the strongest correlation existed between MDNS and NCV. None of the procedures had a significant correlation with MNSIQ. MNSIC, which shares

similar characteristics with MDNS, had significant relation with MDNS and NCV, but

its sensitivity was low.

Conclusion : MNSIQ and MNSIC were not useful as Inning instruments in the diagnostic approach to diabetic neuropathy using Feldman's method. Thus, a new

questionnaire composed of symptoms common in Korean diabetic patients should be

designed, and MNSIC could be omitted from the diagnostic approach.
Keywords
Diabetic neuropathyDiagnosis
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Journal Papers > School of Medicine / Graduate School of Medicine > Endocrinology & Metabolism
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