Optimal cut‐off value of the modified Toronto Clinical Neuropathy Score in the diagnosis of polyneuropathy

Abstract

AbstractBackground and purposeThe modified Toronto Clinical Neuropathy Score (mTCNS) is a valid and reliable scale for the diagnosis and staging of diabetic sensorimotor polyneuropathy (DSP). The aim of this study was to determine the optimal diagnostic cut‐off value of the mTCNS in diverse polyneuropathies (PNPs).MethodsDemographics and mTCNS values were retrospectively extracted from an electronic database of 190 patients with PNP and 20 normal controls. Sensitivity, specificity, and likelihood ratios and area under the receiver‐operating characteristic (ROC) curve were determined for each diagnosis and different cut‐off values of the mTCNS. Patients underwent clinical, electrophysiological and functional assessments of their PNP.ResultsForty‐three percent of PNP was related to diabetes or impaired glucose tolerance. mTCNS was significantly higher in patients with PNP than in those without (15.27 ± 8 vs. 0.79 ± 1.4; p = 0.001). The cut‐off value for diagnosing PNP was ≥3 (sensitivity 98.4%, specificity 85.7%, positive likelihood ratio 6.88). The area under the ROC curve was 0.987.ConclusionA value of 3 or more on the mTCNS is recommended for the diagnosis of PNP.