Application of the Ipswich Touch Test for diabetic peripheral neuropathy screening: a systematic review and meta-analysis
Objective Diabetic 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 operat...
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BMJ Publishing Group
2021-10-01
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| Series: | BMJ Open |
| Online Access: | https://bmjopen.bmj.com/content/11/10/e046966.full |
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| author | Jing Zhou Nan Zhao Qiuhong Zhou Xinyi Li Feng Zhou Jingcan Xu Jiarui Chen Jinghong Liang |
| author_facet | Jing Zhou Nan Zhao Qiuhong Zhou Xinyi Li Feng Zhou Jingcan Xu Jiarui Chen Jinghong Liang |
| author_sort | Jing Zhou |
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| description | Objective Diabetic 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.Design Systematic review and meta-analysis.Data sources PubMed, Embase, Cochrane Library, Web of Science, China National Knowledge Infrastructure, Wanfang, Chinese Biomedical Literature Database up to 16 April 2020.Methods Stata 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).Results Of 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.Conclusions IPTT 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 number Registration Number is CRD (42020168420). |
| format | Article |
| id | doaj-art-36ffd66dd94a482ba6080f575b5a1d92 |
| institution | OA Journals |
| issn | 2044-6055 |
| language | English |
| publishDate | 2021-10-01 |
| publisher | BMJ Publishing Group |
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| spelling | doaj-art-36ffd66dd94a482ba6080f575b5a1d922025-08-20T02:21:18ZengBMJ Publishing GroupBMJ Open2044-60552021-10-01111010.1136/bmjopen-2020-046966Application of the Ipswich Touch Test for diabetic peripheral neuropathy screening: a systematic review and meta-analysisJing Zhou0Nan Zhao1Qiuhong Zhou2Xinyi Li3Feng Zhou4Jingcan Xu5Jiarui Chen6Jinghong Liang7Department of Cardiology, Peking University First Hospital, Beijing, ChinaDepartment of Medicine, Jewish General Hospital, Montreal, Quebec, Canada3 Teaching and Research Section of Clinical Nursing, Xiangya Hospital Central South University, Changsha, Hunan, ChinaXiangya Nursing School, Central South University, Changsha, Hunan, ChinaIntensive Care Unit, Guangzhou Medical University Second Affiliated Hospital, Guangzhou, Guangdong, ChinaXiangya center for Evidence-Based Practice & Healthcare Innovation: A Joanna Briggs Institute Affiliated Group, Changsha, Hunan, ChinaXiangya School of Nursing, Central South University, Changsha, Hunan, China1 Department of Maternal and Child Health, School of Public Health, Sun Yat-Sen University, Guangzhou, ChinaObjective Diabetic 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.Design Systematic review and meta-analysis.Data sources PubMed, Embase, Cochrane Library, Web of Science, China National Knowledge Infrastructure, Wanfang, Chinese Biomedical Literature Database up to 16 April 2020.Methods Stata 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).Results Of 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.Conclusions IPTT 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 number Registration Number is CRD (42020168420).https://bmjopen.bmj.com/content/11/10/e046966.full |
| spellingShingle | Jing Zhou Nan Zhao Qiuhong Zhou Xinyi Li Feng Zhou Jingcan Xu Jiarui Chen Jinghong Liang Application of the Ipswich Touch Test for diabetic peripheral neuropathy screening: a systematic review and meta-analysis BMJ Open |
| title | Application of the Ipswich Touch Test for diabetic peripheral neuropathy screening: a systematic review and meta-analysis |
| title_full | Application of the Ipswich Touch Test for diabetic peripheral neuropathy screening: a systematic review and meta-analysis |
| title_fullStr | Application of the Ipswich Touch Test for diabetic peripheral neuropathy screening: a systematic review and meta-analysis |
| title_full_unstemmed | Application of the Ipswich Touch Test for diabetic peripheral neuropathy screening: a systematic review and meta-analysis |
| title_short | Application of the Ipswich Touch Test for diabetic peripheral neuropathy screening: a systematic review and meta-analysis |
| title_sort | application of the ipswich touch test for diabetic peripheral neuropathy screening a systematic review and meta analysis |
| url | https://bmjopen.bmj.com/content/11/10/e046966.full |
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