Article Text

This article has a correction. Please see:

Download PDFPDF
Clinical validation of methods of diagnosis of neuropathy in a field study of United Kingdom sheep dippers
  1. D Buchanan1,
  2. G A Jamal3,
  3. A Pilkington2,
  4. S Hansen4
  1. 1ISD, Scottish Executive, Edinburgh, UK
  2. 2Wellwork Ltd, Edinburgh, UK
  3. 3Department of Neurology, Charing Cross Hospital, London, UK
  4. 4Department of Neurology, INS, Southern General Hospital, Glasgow, UK
  1. Correspondence to:
 Dr S Hansen, Department of Clinical Physics, Southern General Hospital, 1345 Govan Road, Glasgow G51 4TF, UK;
 adele{at}wellwork.co.uk

Abstract

Objectives: To investigate the reproducibility of measured indices of chronic peripheral neuropathy from a field study of sheep dippers when compared with similar measurements carried out in a clinical setting.

Methods: A stratified random sample of field study subjects was invited to attend a clinic. Neuropathy was measured both in the field and at the clinic with a modified version of a standard symptoms questionnaire and quantitative sensory thresholds for hot, cold, and vibration. These were combined into a classification of the likelihood of neuropathy with a neuropathy scoring system. Indicators of sensory abnormality were based on comparison of sensory thresholds to age dependent reference values derived from an external reference group.

Results: Only 51% of subjects were assigned similar classifications in the field and clinic based on the neuropathy scoring system. Of the component indices, grouped symptom scores, with 65% of subjects showing exact agreement, proved to be more reproducible than quantitative sensory test indicators. There were biases in the comparison of field and clinic measurements of hot and vibration sensations, but no evidence of greater variation between individual people in sensory thresholds in the field relative to at the clinic.

Conclusions: The neuropathy scoring system proved to be of limited reproducibility, due in a large part to the lack of reproducibility of the indicators of sensory test abnormality caused by inadequate temperature control. However, the symptoms score and measured sensory thresholds could be used separately as indices of neuropathy in exposure-response analyses.

  • chronic peripheral neuropathy
  • reproducibility
  • scoring system
  • OPs, organophosphates
  • Ip, index of nerve pathology
  • QST, quantitative sensory tests

Statistics from Altmetric.com

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.

Footnotes

Linked Articles

  • Correction
    BMJ Publishing Group Ltd