Diagnostic accuracy of the VibraTip in detection of diabetic peripheral neuropathy

Abstract

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 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 PN +ve subjects. However no statistically significant difference in specificity (6%) (p<0.25) was seen for PN-ve subjects. 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 practice.