Duygu Aktar REYHANİOĞLU, Süleyman Cem ADIYAMAN, Murat BEKTAŞ, Onur BULUT, Başak Özgen SAYDAM, Fırat BAYRAKTAR, Bilge KARA

Validity and reliability of the Turkish version of the Michigan Neuropathy Screening Instrument

Background/aim: The aim of this study was to demonstrate the validity and reliability of the Turkish version of the Michigan Neuropathy Screening Instrument MNSI-TR . Materials and methods: The study included 127 patients aged 45-76 years who were previously diagnosed with type 1 or 2 diabetes. Stability of the instrument was assessed by intraclass correlation coefficient. Reliability of the MNSI-TR was assessed using the Kuder- Richardson formula 20 test, item-total correlations, and floor/ceiling effect. Validity was evaluated with receiver operating characteristic curve analysis. A logistic regression model was used to determine to what degree the MNSI-TR explain nerve conduction study NCS results in the prediction of neuropathy. Results: With a cut-off value of 3.5 for the questionnaire, sensitivity and specificity of the MNSI-TR were 75.5% and 68.1%, respectively. A cut-off of 2.75 for the physical assessment part of the scale resulted in 87.5% sensitivity and 93.6% specificity. The scale was able to diagnose neuropathy in the rate of 71.5% of the patients diagnosed with neuropathy by NCS. Conclusion: The MNSI-TR is a valid and reliable method for evaluating diabetic peripheral neuropathy in Turkish speaking societies. It must be obtained a minimum of 4 points from the questionnaire part and a minimum of 2.5 points from the physical assessment part for the diagnosis of neuropathy

Keywords:

Michigan, diabetic neuropathy, diabetes mellitus, reproducibility of results,

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1. Chaudhury A, Duvoor C, Dendi R, Sena V, Kraleti S et al. Clinical review of antidiabetic drugs: Implications for type 2 diabetes mellitus management. Frontiers in Endocrinology 2017; 8 (6). doi: 10.3389/fendo.2017.00006
2. Çakici N, Fakkel TM, Van Neck JW, Verhagen AP, Coert JH. Systematic review of treatments for diabetic peripheral neuropathy. Diabetic Medicine 2016; 33 (11): 1466-1476. doi: 10.1111/dme.13083
3. Qureshi MS, Iqbal M, Zahoor S, Ali J, Javed MU. Ambulatory screening of diabetic neuropathy and predictors of its severity in outpatient settings. Journal of endocrinological investigation. 2016; 40 (4): 425-430. doi: 10.1007/s40618-016- 0581-y
4. Hershey DS. Diabetic Peripheral Neuropathy: Evaluation and Management. The journal for nurse practitioners:JNP 2017; 13 (3): 199-204. doi: 10.1016/j.nurpra.2016.08.034
5. Russell JW, Zilliox LA. Diabetic neuropathies. Continuum (Minneapolis, Minn.) 2014; 20 (5): 1226. doi: 10.1212/01.CON.0000455884.29545.d2
6. Yang Z, Chen R, Zhang Y, Huang Y, Hong T et al. Scoring systems to screen for diabetic peripheral neuropathy. The Cochrane database of systematic reviews. 2014; 3. doi: 10.1002/14651858.CD010974.pub2
7. Tesfaye S, Vileikyte L, Rayman G, Sindrup SH, Perkins BA et al. Painful diabetic peripheral neuropathy: consensus recommendations on diagnosis, assessment and management. Diabetes/metabolism research and reviews. 2011; 27 (7): 629-638. doi: 10.1002/dmrr.1225
8. Smith AG. Do all neuropathy patients need an EMG at least once?. Continuum (Minneapolis, Minn.) 2014; 20 (5): 1430- 1434. doi: 10.1212/01.CON.0000455870.45685.c7.
9. Theriault M, Dort J, Sutherland G, Zochodne DW. A prospective quantitative study of sensory deficits after whole sural nerve biopsies in diabetic and nondiabetic patients. Surgical approach and the role of collateral sprouting. Neurology 1998; 50 (2): 480-484. doi:10.1212/wnl.50.2.480
10. Kennedy WR, Nolano M, Wendelschafer-Crabb G, Johnson TL, Tamura E. A skin blister method to study epidermal nerves in peripheral nerve disease. Muscle & Nerve 1999; 22 (3): 360- 371. doi: 10.1002/(SICI)1097-4598(199903)22:33.0.CO;2-J
11. Kennedy WR, Wendelschafer-Crabb G, T. Johnson. Quantitation of epidermal nerves in diabetic neuropathy. Neurology 1996; 47 (4): 1042-1048. doi: 10.1212/wnl.47.4.1042
12. Dahlin LB, Eriksson KF, Sundkvist G. Persistent postoperative complaints after whole sural nerve biopsies in diabetic and non-diabetic subjects. Diabetic Medicine 1997; 14 (5): 353- 356. doi: 10.1002/(SICI)1096-9136(199705)14:53.0.CO;2-E
13. Wilbourn AJ. Diabetic neuropathies. In: Brown WF, Bolton CF (editors). Clinical electromyography. Butterworth Heinemann, Toronto; 1993. pp. 477-515
14. Feldman EL, Stevens MJ, Thomas PK, Brown MB, Canal N et al. A practical two-step quantitative clinical and electrophysiological assessment for the diagnosis and staging of diabetic neuropathy. Diabetes Care 1994; 17 (11): 1281- 1289. doi: 10.2337/diacare.17.11.1281
15. Lunetta M, Le Moli R, Grasso G, Sangiorgio L. A simplified diagnostic test for ambulatory screening of peripheral diabetic neuropathy. Diabetes Research and Clinical Practice 1998; 39 (3): 165-172. doi: 10.1016/S0168-8227(98)00005-9
16. Moghtaderi A, Bakhshipour A, Rashidi H. Validation of Michigan neuropathy screening instrument for diabetic peripheral neuropathy. Clinical Neurology and Neurosurgery 2006; 108 (5): 477-481. doi: 10.1016/j.clineuro.2005.08.003
17. Herman WH, Pop‐Busui R, Braffett BH, Martin CL, Cleary PA et al. Use of the Michigan Neuropathy Screening Instrument as a measure of distal symmetrical peripheral neuropathy in type 1 diabetes: results from the Diabetes Control and Complications Trial/Epidemiology of Diabetes Interventions and Complications. Diabetic Medicine 2012; 29 (7): 937-944. doi: 10.1111/j.1464-5491.2012.03644.x
18. Barbosa M, Saavedra A, Severo M, Maier C, Carvalho D. Validation and reliability of the Portuguese version of the Michigan Neuropathy Screening Instrument. Pain Practice 2017; 17 (4): 514-521. doi: 10.1111/papr.12479
19. Oliveira FBD, Botelho KKP, Bezerra AR, Azevedo DIDO, Santos-Couto-Paz CCD et al. Cross-cultural adaptation to Brazilian Portuguese of the Michigan neuropathy screening instrument: MNSI-Brazil. Arquivos de Neuro-Psiquiatria 2016; 74: (8) 653-661. doi: 10.1590/0004-282X20160094
20. American Diabetes Association. Diagnosis and classification of diabetes mellitus. Diabetes Care 2010; 33 (Supplement 1): S62-S69. doi: 10.2337/dc10-S062
21. Preston DC, Shapiro BE. Polyneuropathy In: Preston DC, Shapiro BE (editors). Electromyography and Neuromuscular Disorders: Clinical–Electrophysiologic Correlations. 3rd ed. Elsevier Inc, China; 2013. pp. 384-416. doi: 0.1016/B978-1- 4557-2672-1.00026-X.
22. Beaton DE, Bombardier C, Guillemin F, Ferraz MB. Guidelines for the process of cross-cultural adaptation of self-report measures. Spine 2000; 25 (24): 3186-3191. doi: 10.1097/00007632-200012150-00014
23. Davis LL. Instrument review: Getting the most from your panel of experts. Applied nursing research : ANR 1992; 5 (4): 194-197. doi: 10.1016/S0897-1897(05)80008-4
24. Polit DF, Beck CT, Owen SV. Is the CVI an acceptable indicator of content validity? Appraisal and recommendations. Research in nursing & health 2007: 30 (4); 459-467. doi: 10.1002/ nur.20199
25. Şencan H. Sosyal ve davranışsal ölçümlerde güvenilirlik ve geçerlilik. 1st ed. Ankara, Turkey: Seckin Yayınevi; 2005 (in Turkish).
26. Cam MO, Baysan-Arabacı L. Qualitative and quantitative steps on attitude scale construction. Turkish Journal of Research & Development in Nursing 2010; 12 (2): 59-71.
27. Terwee CB, Bot SD, Boer MR, van der Windt DA, Knol DL et al. Quality criteria were proposed for measurement properties of health status questionnaires. Journal of clinical epidemiology 2007; 60 (1): 34–4. doi: 10.1016/j.jclinepi.2006.03.012
28. DeVellis RF. Scale Development, Theory and Applications, 3rd ed. London, UK: Sage; 2012.
29. Dirican A. Tanı testi performansının değerlendirilmesi ve kıyaslanması Cerrahpaşa Tıp Dergisi 2001; 32 (1): 25-30 (in Turkish).
30. Youden WJ. Index for rating diagnostic tests. Cancer 1950; 3 (1): 32-35. doi: 10.1002/1097-0142(1950)3:13.0.CO;2-3