Multi-Site Testing With a Point-of-Care Nerve Conduction Device Can Be Used in an Algorithm to Diagnose Diabetic

OBJECTIVE — We aimed to establish whether multi-nerve testing with a point-of-care nerve conduction device could be used to diagnose diabetic sensorimotor polyneuropathy. RESEARCH DESIGN ANDMETHODS — A total of 72 consecutive patients with dia-betes underwent a full neurological examination and a concurrent evaluation for nine standard electrophysiological parameters using conventional nerve conduction studies (the reference standard) and a point-of-care device. RESULTS — Spearman coefficients for correlation of point-of-care and conventional param-eters ranged between 0.76 and 0.91 (P 0.001 in all comparisons). Agreement by the method of Bland and Altman was acceptable despite small systematic biases. Fifty subjects (69%) had neuropathy according to conventional criteria. The sensitivity and specificity for the point-of-care device to identify such neuropathy was 88 and 82%, respectively. CONCLUSIONS — A novel point-of-care device has reasonable diagnostic accuracy and thus may represent a sufficiently accurate alternative for detecting the diffuse electrophysiolog-ical criteria necessary to make the diagnosis of diabetic sensorimotor polyneuropathy. Diabetes Care 31:522–524, 2008 U niversal nerve conduction studytesting for suspected neuropathy isnot feasible due to limitations in availability of specialized laboratories (1– 3). Simplified automated devices usable by nontechnicians have been developed and validated for conditions other than diabetic sensorimotor polyneuropathy (4 – 6). As such, we aimed to evaluate agreement and accuracy for such neurop-athy by a point-of-care device