Validation of the Ipswich Touch Test for Diabetic Peripheral Neuropathy Screening in Primary Care

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Ponlawat Hanchana
Dolnapa Kaewpaitoon
Rangsan Suttiprapa


BACKGROUND: Diabetic foot, a severe complication of diabetes, significantly impairs the quality of life for affected individuals. However, it can be prevented through screening for loss of protective sensation in the foot. Currently, standard screening methods still require specialized equipment and trained medical professionals.

OBJECTIVES: This study aims to assess the accuracy of screening for diabetic peripheral neuropathy by comparing the Ipswich touch test with the 10-g monofilament test in patients diagnosed with type 2 diabetes.

METHODS: This diagnostic study with a cross-sectional design focused on a group of 274 patients with type 2 diabetes who were receiving services at Nong Khantee Sub-district Health Promoting Hospital in Phra Phutthabat District, Saraburi Province. Participants underwent both the Ipswich touch test and the 10-g monofilament test. Statistical analysis included the evaluation of sensitivity, specificity, negative predictive value, positive predictive value, negative likelihood ratio, positive likelihood ratio, and Cohen’s kappa statistic to assess the diagnostic reliability of the Ipswich touch test.

RESULTS: The majority of patients were women, accounting for 64.2%, with an average age of 62.5 years. When compared to the 10-g monofilament test, the accuracy of the Ipswich touch test showed a sensitivity of 73.4%, specificity of 99.0%, positive predictive value of 95.9%, negative predictive value of 92.4%, positive likelihood ratio of 77.11, and negative likelihood ratio of 0.27. The Kappa index, indicating agreement, was 0.79 (p <0.001).

CONCLUSIONS: The Ipswich touch test exhibited good sensitivity, high specificity, and concordance with the 10-g monofilament test, suggesting its potential application for screening diabetic peripheral neuropathy, especially in primary healthcare units where equipment is limited. Identifier, NCT06288555

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