Semmes Weinstein monofilament test for detection of diabetic peripheral neuropathy: sensitivity and specificity

Peripheral neuropathy predisposes to diabetic foot and this predilection is worsened by poorly controlled sugars. Diabetic foot increases the mortality and morbidity associated with diabetes. Thus, it is crucial to screen for diabetic polyneuropathy. Early detection of diabetic polyneuropathy improves foot care and decreases morbidity. This study aimed to assess the sensitivity of Semmes Weinstein monofilament test in the diagnosis of Diabetic Peripheral Neuropathy. Forty-three Type 2 diabetes mellitus patients availing IP/OP services of a Medical College Hospital were included for the study. Patients underwent Semmes Weinstein monofilament test, following which they were subjected to nerve conduction study of both lower limbs.

Forty six and half percentage of patients had diabetic peripheral neuropathy, taking NCS as gold standard.Of these 80% of the cases were also detected by the monofilament test.The specificity of the monofilament test was 100%. Positive predictive value was 100% and negative predictive value was 85.19% and the overall accuracy of the test was 90.7%.

In this study, we found that sensitivity and specificity of the SWM test are fairly high; thus, it can be used as a valid screening tool for DPN in resource limited settings, such as India.