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Review
. 2009 Nov-Dec;7(6):555-8.
doi: 10.1370/afm.1016.

Accuracy of monofilament testing to diagnose peripheral neuropathy: a systematic review

Jacquelien Dros  1 , Astrid Wewerinke, Patrick J Bindels, Henk C van Weert
Affiliations
Review

Accuracy of monofilament testing to diagnose peripheral neuropathy: a systematic review

Jacquelien Dros et al. Ann Fam Med. 2009 Nov-Dec.

Abstract

Purpose: We wanted to summarize evidence about the diagnostic accuracy of the 5.07/10-g monofilament test in peripheral neuropathy.

Methods: We conducted a systematic review of studies in which the accuracy of the 5.07/10-g monofilament was evaluated to detect peripheral neuropathy of any cause using nerve conduction as reference standard. Methodological quality was assessed using the Quality Assessment of Diagnostic Accuracy Studies (QUADAS) tool.

Results: We reviewed 173 titles and abstracts of articles to identify 54 potentially eligible studies, of which 3 were finally selected for data synthesis. All studies were limited to patients with diabetes mellitus and showed limitations according to the QUADAS tool. Sensitivity ranged from 41% to 93% and specificity ranged from 68% to 100%. Because of the heterogenous nature of the studies, a meta-analysis could not be accomplished.

Conclusions: Despite the frequent use of monofilament testing, little can be said about the test accuracy for detecting neuropathy in feet without visible ulcers. Optimal test application and defining a threshold should have priority in evaluating monofilament testing, as this test is advocated in many clinical guidelines. Accordingly, we do not recommend the sole use of monofilament testing to diagnose peripheral neuropathy.

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Figure 1.
Figure 1.
Flowchart of the study selection process.
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References

    1. American Diabetes Association. Standards of medical care in diabetes—2008. Diabetes Care. 2008;31(Suppl 1):S12–S54. - PubMed
    1. Boulton AJ, Vinik AI, Arezzo JC, et al.; American Diabetes Association. Diabetic neuropathies: a statement by the American Diabetes Association. Diabetes Care. 2005;28(4):956–962. - PubMed
    1. Dyck PJ, Kratz KM, Karnes JL, et al. The prevalence by staged severity of various types of diabetic neuropathy, retinopathy, and nephropathy in a population-based cohort: the Rochester Diabetic Neuropathy Study. Neurology. 1993;43(4):817–824. - PubMed
    1. England JD, Gronseth GS, Franklin G, et al. Distal symmetric polyneuropathy: a definition for clinical research: report of the American Academy of Neurology, the American Association of Electrodiagnostic Medicine, and the American Academy of Physical Medicine and Rehabilitation. Neurology. 2005;64(2):199–207. - PubMed
    1. Dutch Association of Neurology (NVN), Dutch Association of Clinical Neurophysiology (NVKNF). Guideline Polyneuropathy of the Dutch Institute for Healthcare Improvement (CBO). Alphen a/d Rijn, the Netherlands: van Zuiden; 2005.
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