Diagnostic accuracy of qualitative versus quantitative tuning forks: outcome measure for neuropathy.
Diagnostic accuracy of qualitative versus quantitative tuning forks: outcome measure for neuropathy.
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DOI：
10.1097/cnd.0000000000000019
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发表时间：
2014-03-01
影响因子：
--
通讯作者：
Ramchandren, Sindhu
中科院分区：
文献类型：
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作者：
Lai, Saien;Ahmed, Umair;Ramchandren, Sindhu
目的：评价Rydel-Seiffer音叉与128 Hz定性音叉诊断感觉神经轴索病变的准确性。方法：收集100例在某主要学术中心神经科门诊就诊的患者，并同意本研究。对神经传导研究结果视而不见的研究人员收集了两个音叉在双侧(1)大脚趾和(2)远端指间关节在第二个手指上的振动感知数据。用已发表的标准数据判定Rydel-Seiffer音叉和定性音叉的异常评分；根据我们的肌电实验室标准，根据感觉神经动作电位波幅判定轴索性神经病。结果：对100例患者的186条感觉神经进行了音叉和神经传导检查。Rydel-Seiffer音叉诊断轴索神经病的灵敏度和特异度分别为26%和89%，常规128 Hz音叉诊断轴索神经病的灵敏度和特异度分别为20%和88%。扩展McNemar检验显示两种音叉的敏感度和特异度无显著差异(X_1=1.695；P=0.43)。结论：Rydel-Seiffer音叉和传统音叉对感觉神经轴索病变的诊断准确率没有差异，但Rydel-Seiffer音叉更易于使用，在纵向评估方面可能更好。
OBJECTIVE: To assess the diagnostic accuracy of the Rydel-Seiffer tuning fork versus the qualitative 128-Hz tuning fork for detecting sensory axonal neuropathy.METHODS: One hundred consecutive patients seen at the Neurology Outpatient Electromyography clinic at a major academic center were recruited and consented for this study. Study personnel who were blinded to results of nerve conduction studies collected data on vibratory perception with both tuning forks at bilateral (1) great toe and (2) distal interphalangeal joint on the second digit. Published normative data were used to determine abnormal scores for the Rydel-Seiffer tuning fork and the qualitative tuning fork; axonal neuropathy was determined based on sensory nerve action potential amplitudes as per our electromyography laboratory standards.RESULTS: A total of 186 sensory nerves from 100 patients were tested with tuning forks and nerve conduction studies. The sensitivity and specificity of the Rydel-Seiffer tuning fork to detect axonal neuropathy was 26% and 89%, respectively, and the sensitivity and specificity of the conventional 128-Hz tuning fork to detect axonal neuropathy was 20% and 88%, respectively. The extended McNemar test showed no significant difference in sensitivity or specificity between the 2 tuning forks (chi = 1.695; P = 0.43).CONCLUSIONS: There is no difference in diagnostic accuracy between the Rydel-Seiffer tuning fork and conventional tuning fork for detecting sensory axonal neuropathies; however, the Rydel-Seiffer is easier to use and may be superior for longitudinal assessments.