Validation of the Filipino-Translated Version of the Michigan Neuropathy Screening Instrument among Filipino Patients with Diabetes Mellitus Seen at the Philippine General Hospital

Abstract

Objectives. To assess the validity of the Filipino-translated version of the Michigan Neuropathy Screening Instrument(MNSI) in screening for diabetic neuropathy among Filipino patients with diabetes mellitus using nerve conduction velocity(NCV) as gold standard and to determine the most accurate cut-off score for the diagnosis of neuropathy using MNSI. Methodology. A cross-sectional analytic study was done among adult diabetic patients. The original MNSI Questionnaire was translated and back-translated to the Filipino language. Each patient answered the Filipino version of MNSI Questionnaire followed by a lower extremity examination done by the investigator. All patients underwent NCV as reference standard. Sensitivity and specificity of MNSI were determined. Results. We studied a total of 150 subjects. Eighty-seven (58%) were diagnosed to have diabetic neuropathy based on NCV. The sensitivity and specificity of the MNSI Questionnaire improved to 73.6% and 52.4% respectively when the cut off was reduced to ≥4, whereas for the MNSI Examination, the sensitivity and specificity improved to 86.2% and 55.6% respectively when the cut off was reduced to ≥1. Combining both MNSI Questionnaire and MNSI Examination further improves the sensitivity to 95.4% whereas specificity is at 39.7%. Conclusion. The analyses in 150 subjects confirm that the Filipino-version of MNSI is a valid screening tool for diabetic neuropathy when compared with NCV as gold standard.

Keywords

• diabetic neuropathy
• questionnaire
• Filipino
• diabetes mellitus