Symptom scoring systems to diagnose distal polyneuropathy in diabetes: the Diabetic Neuropathy Symptom score

AIMS: To provide one of the diagnostic categories for distal diabetic polyneuro-pathy,several symptom scoring systems are available, which are often extensive andlack in validation. We validated a new four-item Diabetic Neuropathy Symptom (DNS) scorefor diagnosing distal diabetic polyneuropathy. METHODS: We compared score characteristics of the generally accepted NeuropathySymptom Score (NSS) with the DNS score, and tested construct validity,predictive value and reproducibility with the Diabetic Neuropathy Examinationscore, Semmes-Weinstein monofilaments and Vibration Perception Threshold(clinical standards) in 73 patients with diabetes (24 Type 1, 49 Type 2;43 male/30 female; mean age 57 years (19-90);mean diabetes duration 15 years (1-43)). RESULTS: Correlation between NSS and DNS score was high (Spearman r= 0.88). Patient scoreswere more differentiated on the DNS score. The relation of the NSS andDNS scores, respectively, with clinical standards was good (Spearman r= 0.21-0.60). Reproducibility ofthe DNS score was high (Cohen weighted kappa 0.78-0.95). The DNSscore was easier to perform in clinical practice. CONCLUSIONS: The DNS is validated, fast and easy to perform, with a high predictive valuewhen screening for diabetic polyneuropathy. Diabet. Med. 19, 962-965 (2002