Document Detail

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.
MedLine Citation:
PMID:  15668414     Owner:  NLM     Status:  MEDLINE    
The objective of this report was to develop a case definition of distal symmetric polyneuropathy to standardize and facilitate clinical research and epidemiologic studies. A formalized consensus process was employed to reach agreement after a systematic review and classification of evidence from the literature. The literature indicates that symptoms alone have relatively poor diagnostic accuracy in predicting the presence of polyneuropathy; signs are better predictors of polyneuropathy than symptoms; and single abnormalities on examination are less sensitive than multiple abnormalities in predicting the presence of polyneuropathy. The combination of neuropathic symptoms, signs, and electrodiagnostic findings provides the most accurate diagnosis of distal symmetric polyneuropathy. A set of case definitions was rank ordered by likelihood of disease. The highest likelihood of polyneuropathy (useful for clinical trials) occurs with a combination of multiple symptoms, multiple signs, and abnormal electrodiagnostic studies. A modest likelihood of polyneuropathy (useful for field or epidemiologic studies) occurs with a combination of multiple symptoms and multiple signs when the results of electrodiagnostic studies are not available. A lower likelihood of polyneuropathy occurs when electrodiagnostic studies and signs are discordant. For research purposes, the best approach to defining distal symmetric polyneuropathy is a set of case definitions rank ordered by estimated likelihood of disease. The inclusion of this formalized case definition in clinical and epidemiologic research studies will ensure greater consistency of case selection.
J D England; G S Gronseth; G Franklin; R G Miller; A K Asbury; G T Carter; J A Cohen; M A Fisher; J F Howard; L J Kinsella; N Latov; R A Lewis; P A Low; A J Sumner; ; ;
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Publication Detail:
Type:  Consensus Development Conference; Guideline; Journal Article; Practice Guideline; Review    
Journal Detail:
Title:  Neurology     Volume:  64     ISSN:  1526-632X     ISO Abbreviation:  Neurology     Publication Date:  2005 Jan 
Date Detail:
Created Date:  2005-01-25     Completed Date:  2005-09-20     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  0401060     Medline TA:  Neurology     Country:  United States    
Other Details:
Languages:  eng     Pagination:  199-207     Citation Subset:  AIM; IM    
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MeSH Terms
Clinical Protocols
Clinical Trials as Topic
Diabetic Neuropathies / classification,  diagnosis
Diagnosis, Differential
Diagnostic Techniques, Neurological*
Evidence-Based Medicine
Expert Testimony
Neural Conduction
Neurologic Examination
Polyneuropathies / classification,  diagnosis*,  epidemiology
Reflex, Abnormal
Sensitivity and Specificity
Societies, Medical
Terminology as Topic

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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