Signs and symptoms versus nerve conduction studies to diagnose diabetic sensorimotor polyneuropathy: Cl vs. NPhys trial.
Signs and symptoms versus nerve conduction studies to diagnose diabetic sensorimotor polyneuropathy: Cl vs. NPhys trial.
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DOI：
10.1002/mus.21661
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发表时间：
2010-08
期刊：
影响因子：
3.4
通讯作者：
O'Brien, Peter C.
中科院分区：
文献类型：
--
作者：
Dyck, Peter J.;Overland, Carol J.;Low, Phillip A.;Litchy, William J.;Davies, Jenny L.;Dyck, P. James B.;O'Brien, Peter C.
测试医生是否可以有效和可重复地诊断糖尿病感觉运动性多发性神经病（DSPN）。12名医生评估了24例糖尿病（DM）患者连续几天（576次检查）的身体特征和声音伪装。将结果与金标准75%组诊断和神经传导评分（105 NC nds）进行比较。实现了患者的掩蔽。通过kappa系数测量的生殖能力与105 NC nd相比，医生之间差异很大：中位数和范围：体征0.8（0.32 - 1.0）;症状0.79（0.36 - 1.0）和诊断0.47（0.33 - 0.84）-低和高分均表示性能较差。75%的dx组与确认的NC异常之间存在实质性一致性。与2005年NC相比，个别医生的临床诊断变化太大，而且经常不准确。研究医生根据体征和症状做出的诊断差异过大，经常高估DSPN。应测试提高熟练程度的具体方法。
Test whether physicians can validly and reproducibly diagnose diabetic sensorimotor polyneuropathy (DSPN). Twelve physicians assessed 24 patients with diabetes mellitus (DM) on consecutive days (576 examinations) with physical features and voice disguised. Results were compared to gold standard 75% group diagnosis and a nerve conduction score (Σ 5 NC nds). Masking of patients was achieved. Reproducibility measured by the kappa coefficient and compared to Σ 5 NC nd varied considerably among physicians: median and ranges: signs 0.8 (0.32 to 1.0); symptoms 0.79 (0.36 to 1.0) and diagnoses 0.47 (0.33 to 0.84) – both low and high scores indicating poor performance. There was substantial agreement between 75% group dx and confirmed NC abnormality. As compared to Σ 5 NC, individual physicians’ clinical diagnosis was excessively variable and frequently inaccurate. Study physician diagnosis from signs and symptoms were excessively variable, often over-estimating DSPN. Specific approaches to improving proficiency should be tested.
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影响因子：
9.9
作者：
DYCK, PJ;LITCHY, WJ;OBRIEN, PC
通讯作者：
OBRIEN, PC
影响因子：
16.2
作者：
Cowie, Catherine C.;Engelgau, Michael M.;Gregg, Edward W.
通讯作者：
Gregg, Edward W.
影响因子：
9.9
作者：
England, JD;Gronseth, GS;Sumner, AJ
通讯作者：
Sumner, AJ
影响因子：
3.4
作者：
Dyck, PJ;Litchy, WJ;O'Brien, PC
通讯作者：
O'Brien, PC
影响因子：
16.2
作者：
Narayan, K. M. Venkat;Saaddine, Jinan B.;Geiss, Linda S.
通讯作者：
Geiss, Linda S.