Application of the Ipswich Touch Test for diabetic peripheral neuropathy screening: a systematic review and meta-analysis

Abstract

ObjectiveDiabetic peripheral neuropathy (DPN) is one of the most important risk factors of diabetic foot ulcers, and early screening and treatment of DPN are crucial. The Ipswich Touch Test (IPTT) is a new method for screening for DPN and, compared with traditional methods, is more simple to operate and requires no equipment. However, the screening accuracy of IPTT in patients with DPN has not been well characterised. We aim to conduct a systematic review and meta-analysis to characterise the sensitivity and specificity of IPTT compared with traditional methods and to understand the potential screening value of IPTT.DesignSystematic review and meta-analysis.Data sourcesPubMed, Embase, Cochrane Library, Web of Science, China National Knowledge Infrastructure, Wanfang, Chinese Biomedical Literature Database up to 16 April 2020.MethodsStata V.15.1 software was used for analysis, and the screening value of IPTT in DPN was described using 10 g monofilament (10g-MF), neuropathy disability scores (NDS), Pin prick, 128 Hz tuning fork, and ankle reflex as reference standards. Sensitivity, specificity and other measures of accuracy of IPTT for screening DPN were pooled based on a quality effects model. The protocol was registered with PROSPERO (42020168420).ResultsOf the 441 records retrieved, 7 studies were evaluated for the screening value of IPTT. Five studies with 10g-MF as the reference standard were included in the meta-analysis, and the pooled sensitivity and specificity were 0.77 (95％CI 0.69–0.84) and 0.96(95％CI 0.93–0.98), respectively, and the area under curve was 0.897. Compared with vibration perception threshold, IPTT showed a sensitivity between 0.76 and 1, and a specificity between 0.90 and 0.97. Compared with NDS, IPTT showed a sensitivity between 0.53 and 1, and a specificity between 0.90 and 0.97. Compared with Pin prick, IPTT showed a sensitivity and specificity of 0.8 and 0.88, respectively. Compared with 128 Hz tuning fork, IPTT showed a sensitivity and specificity of 0.4 and 0.27, respectively. Compared with ankle reflex, IPTT had a sensitivity of 0.2 and a specificity of 0.97.ConclusionsIPTT shows a high degree of agreement with other commonly used screening tools for DPN screening. It can be used clinically, especially in remote areas and in primary medical institutions, and by self-monitoring patients. More high-quality studies are needed to assess and promote more effective screening practices.PROSPERO registration numberRegistration Number is CRD (42020168420).

A importância do rastreio da neuropatia diabética no Sistema Único de Saúde uma revisão integrativa

“…Considerou-se como variável dependente a presença de perda da sensibilidade protetora plantar, sendo esta categorizada em ausente (não) ou presente (sim) (Vaitkus & Šipylaitė, 2021). O diagnóstico baseou-se na resposta anormal ao teste de sensibilidade protetora ou teste do monofilamento, concomitante a um segundo teste alterado, como o da sensibilidade vibratória, da sensibilidade dolorosa ou do reflexo Aquileu (Zhao, et al, 2021).…”

Screening for diabetic peripheral neuropathy in resource-limited settings

“…Based on current guidelines, there are several criteria for stratifying patients according to their clinical risk for Patients at increased risk for DFS and lower-extremity amputation are recommended to undergo SWME, despite concerns about diagnostic accuracy of SWME during screening for diabetes-related foot disease [104][105][106][107] and questions about the number of sites on the foot that must be assessed [106,107]. In settings where SWME cannot be conducted, the Ipswich Touch Test (IpTT) is a potential substitute assessment that may be used to evaluate LOPS [108][109][110]. However, since no clinical guidelines currently recommend IpTT for risk stratification, more studies are needed to evaluate whether it is an appropriate substitute for SWME.…”

Metode Monofilamen Test dan Ipswich Touch Test (IPTT) untuk Deteksi Neuropati Sensorik Diabetes

“…Metode Penelitian Hasil Penelitian Zhao, N., Xu, J., Zhou, Q., Li, X., Chen, J., Zhou, J., Zhou, F., & Liang, J. (2021).…”

“…Skrining kaki diabetes dilakukan dengan pemeriksaan sensasi yang dilakukan melalui 3 cara yakni ipswich touch test (IpTT), monofilament test, dan garpu tala (Cahyani et al, 2022). Dibandingkan dengan garpu tala 128Hz, monofilament 10g merupakan alat skrining yang paling banyak digunakan karena lebih sederhana, obyektif, dan mudah dibawa (Zhao et al, 2021).…”