Comparative evaluation of several simple screening tests for risk of neuropathic ulcerations of feet in patients with diabetes mellitus

Abstract

Background and Aims: The aim of this study is to compare and evaluate three semi-quantitative screening methods used to predict ulceration risk in diabetic patients: 10 g Semmes-Weinstein monofilament (SW), 128-Hz tuning fork and VibraTip® device. Material and Method: This case-control study was carried out at the Diabetes, Nutrition and Metabolic Diseases Department Cluj-Napoca and included 90 persons distributed into three groups: group A: 30 patients with diabetes mellitus and one or more active neuropathic ulcerations at one foot, group B: 30 patients with diabetes mellitus without ulceration and group C: 30 apparently healthy subjects. The subjects were examined by two independent examiners, using the three screening methods. Results: The agreement kappa coefficient between the two examiners was high and statistically significant. The SW monofilament presented a sensitivity of 71.67% and a specificity of 91.67%. The 128 Hz tuning fork presented a sensitivity of 60% and a specificity of 89.17%. VibraTip® device recorded a sensitivity of 76.66% and a specificity of 77.5%. Conclusions: The highest sensitivity is encountered at the use of VibraTip® device, and the highest specificity is presented by SW monofilament.