Assessment scales for the diagnosis of polyneuropathy

Abstract

Epidemiological studies that investigate the occurrence and determinants of chronic length-dependent polyneuropathy are scarce. Population-based studies on polyneuropathy require a valid and reliable screening protocol with both good sensitivity and specificity. Several questionnaires and scoring scales have been developed for the detection of polyneuropathy, grading the severity of the disease, or evaluating the clinical course during follow-up. This review summarizes the aims and content of existing diagnostic polyneuropathy screening tools in order to help future studies decide which scale to use for screening in specific situations. We searched the PubMed database and identified 27 scales, 13 are based on symptoms alone, 8 on neurological signs alone, and 6 on a combination of symptoms and signs. Scales that combine questions concerning symptoms and a neurological examination with a focus on sensory alterations seem to have the best discriminatory power. However, all scoring scales were developed for and investigated in prespecified patient populations. Therefore, the generalizability of specific findings to the general population may be limited. We also discuss other limitations of existing scales. Future studies are required to determine which clinimetrically well-developed scales are preferred for use in population-based studies.

Diagnostic value of symptoms in chronic polyneuropathy: The Erasmus Polyneuropathy Symptom Score

“…Several questionnaires that combine multiple symptoms have already been reported . These questionnaires were specifically developed for high‐risk patient groups such as patients with diabetes or patients receiving chemotherapy and often require the completion of a neurological examination .…”

“…Some studies report that neuropathic symptoms correlate well with neurological signs or nerve conduction studies and can be adequately used for screening, while other publications state that symptoms alone are not useful for discrimination purposes, because they have poor diagnostic accuracy . Sensitivity and specificity of questionnaires differ widely across studies, ranging from very low (<50%) to relatively high (around 90%) …”

“…Most questionnaires were specifically developed to screen high‐risk populations, for example, patients with diabetes or patients receiving chemotherapy, which limits the generalizability in other populations. No symptom questionnaires for chronic polyneuropathy have been developed and properly validated for screening of a lower‐risk population . Such a questionnaire would be very useful to screen persons in a primary care setting or outpatient clinic, and for chronic polyneuropathy‐related research like population studies.…”

“…[2][3][4][5][6][7][8] Sensitivity and specificity of questionnaires differ widely across studies, ranging from very low (<50%) to relatively high (around 90%). [2][3][4]6,7,9,10 Most questionnaires were specifically developed to screen highrisk populations, for example, patients with diabetes or patients receiving chemotherapy, which limits the generalizability in other populations. No symptom questionnaires for chronic polyneuropathy have been developed and properly validated for screening of a lowerrisk population.…”

“…No symptom questionnaires for chronic polyneuropathy have been developed and properly validated for screening of a lowerrisk population. 10 Such a questionnaire would be very useful to screen persons in a primary care setting or outpatient clinic, and for chronic polyneuropathy-related research like population studies. Additionally, most questionnaires also include non-specific symptoms such as cramps or muscle pain, and apply equal weights to all symptoms.…”