Back to Search
Start Over
Evaluation of the Degree of Agreement of Four Methods for Diagnosing Diabetic Autonomic Neuropathy
- Source :
- Frontiers in Neurology, Frontiers in Neurology, Vol 12 (2021)
- Publication Year :
- 2021
- Publisher :
- Frontiers Media S.A., 2021.
-
Abstract
- Background: There are many methods to diagnose diabetic autonomic neuropathy (DAN); however, often, the various methods do not provide consistent results. Even the two methods recommended by the American Diabetes Association (ADA) guidelines, Ewing's test and heart rate variability (HRV), sometimes give conflicting results. The purpose of this study was to evaluate the degree of agreement of the results of the Composite Autonomic Symptom Score 31 (COMPASS-31), skin sympathetic reaction (SSR) test, Ewing's test, and HRV in diagnosing DAN.Methods: Patients with type 2 diabetes were recruited and each received the COMPASS-31, SSR, Ewing's test, and HRV for the diagnosis of DAN. Patients were categorized as DAN(+) and DAN(–) by each of the tests. Kappa consistency tests were used to evaluate the agreement of diagnosing DAN between any two methods. Spearman's correlation test was used to evaluate the correlations of the severity of DAN between any two methods. Receiver operating characteristic (ROC) analyses were used to evaluate the diagnostic value and the cutoff value of each method.Results: A total of 126 type 2 diabetic patients were included in the study. The percentages of DAN(+) results by HRV, Ewing's test, COMPASS-31, and SSR were 61, 40, 35, and 33%, respectively. COMPASS-31 and Ewing's test had the best agreement for diagnosing DAN (κ = 0.512, p < 0.001). COMPASS-31 and Ewing's test also had the best correlation with respect to the severity of DAN (r = 0.587, p < 0.001). Ewing's test and COMPASS-31 had relatively good diagnostic values (AUC = 0.703 and 0.630, respectively) in the ROC analyses.Conclusions: COMPASS-31 and Ewing's test exhibit good diagnostic consistency and severity correlation for the diagnosis of DAN. Either test is suitable for the diagnosis of DAN and treatment follow-up.
- Subjects :
- COMPASS-31
medicine.medical_specialty
030209 endocrinology & metabolism
Type 2 diabetes
Correlation
03 medical and health sciences
0302 clinical medicine
Internal medicine
Medicine
Heart rate variability
Cutoff
Correlation test
RC346-429
Original Research
Diabetic Autonomic Neuropathy
diabetic autonomic neuropathy
Receiver operating characteristic
business.industry
heart rate variability
diagnostic methods
medicine.disease
Neurology
skin sympathetic reaction
Neurology (clinical)
Neurology. Diseases of the nervous system
Ewing's tests
business
diagnosis agreement
030217 neurology & neurosurgery
Kappa
Subjects
Details
- Language :
- English
- ISSN :
- 16642295
- Volume :
- 12
- Database :
- OpenAIRE
- Journal :
- Frontiers in Neurology
- Accession number :
- edsair.doi.dedup.....dfdb36ec64331feffb783f329c5dfd32