Automated Quantification of Neuropad Improves Its Diagnostic Ability in Patients with Diabetic Neuropathy

作者：Ponirakis Georgios; Fadavi Hassan; Petropoulos Ioannis N; Azmi Shazli; Ferdousi Maryam; Dabbah Mohammad A; Kheyami Ahmad; Alam Uazman; Asghar Omar; Marshall Andrew; Tavakoli Mitra; Al Ahmar Ahmed; Javed Saad; Jeziorska Maria; Malik Rayaz A^*

来源：Journal of Diabetes Research, 2015, 2015: 847854.

DOI：10.1155/2015/847854

Neuropad is currently a categorical visual screening test that identifies diabetic patients at risk of foot ulceration. The diagnostic performance of Neuropad was compared between the categorical and continuous (image-analysis (Sudometrics)) outputs to diagnose diabetic peripheral neuropathy (DPN). 110 subjects with type 1 and 2 diabetes underwent assessment with Neuropad, Neuropathy Disability Score (NDS), peroneal motor nerve conduction velocity (PMNCV), sural nerve action potential (SNAP), Deep Breathing-Heart Rate Variability (DB-HRV), intraepidermal nerve fibre density (IENFD), and corneal confocal microscopy (CCM). 46/110 patients had DPN according to the Toronto consensus. The continuous output displayed high sensitivity and specificity for DB-HRV (91%, 83%), CNFD (88%, 78%), and SNAP (88%, 83%), whereas the categorical output showed high sensitivity but low specificity. The optimal cut-off points were 90% for the detection of autonomic dysDB-HRV) and 80% for small fibre neuropathy (CNFD). The diagnostic efficacy of the continuous Neuropad output for abnormal DB-HRV (AUC: 91%, P = 0.0003) and CNFD (AUC: 82%, P = 0.01) was better than for PMNCV (AUC: 60%). The categorical output showed no significant difference in diagnostic efficacy for these same measures. An image analysis algorithm generating a continuous output (Sudometrics) improved the diagnostic ability of Neuropad, particularly in detecting autonomic and small fibre neuropathy.

• 出版日期2015