The first group consisted of 24 diabetic patients with a history of neuropathic foot ulcers (diabetic ulcer group). For screening we therefore advise the use of the tuning fork alone.Īfter this screening and selection subjects received appointments in a randomized order. The single use of the 128-Hz tuning fork produces results similar to the extended scores of the ICDF and much better than those of monofilaments on validation and for predictive value. Reproducibility of the NDF/CBO scores (monofilaments and tuning fork) was high.ĬONCLUSIONS-The characteristics of the scores of tests recommended by ICDF and NDF/CBO are comparable. The predictive value was good for all scores, with the best results being obtained for the tuning fork (NDF/CBO). RESULTS-The construct validity and discriminative power of the ICDF and NDF/CBO scores were comparable, although monofilaments (NDF/CBO) scored lower. Reproducibility was tested in a separate study (13 patients). The Diabetic Neuropathy Symptom score, the Diabetic Neuropathy Examination score, Heart Rate Variability, the Nerve Conduction Sum score, and a San Antonio Consensus sum score were obtained as clinical standards. In all participants the scores from the International Consensus on the Diabetic Foot (ICDF) and the Dutch Nederlandse Diabetes Federatie-Centraal Beleids Orgaan (NDF/CBO) were tested. RESEARCH DESIGN AND METHODS-Three matched groups were selected: 24 diabetic patients with neuropathic foot ulcers, 24 diabetic patients without PNP or ulcers, and 21 control subjects without diabetes. The variety in these scores and the lack of data on validity and predictive value has led to a comparison and validation of the scores with clinical standards for PNP to determine the most powerful measurement for screening. OBJECTIVE-Several national and international scoring systems are used to diagnose diabetic polyneuropathy (PNP).
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