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Person—peripheral neuropathy indicator, code N

Identifying and definitional attributes

Metadata item type:Help on this termData Element
Short name:Help on this termPeripheral neuropathy (status)
METeOR identifier:Help on this term302457
Registration status:Help on this termHealth, Standard 21/09/2005
Definition:Help on this term

Whether peripheral neuropathy is present, as represented by a code.

Data Element Concept:Person—peripheral neuropathy indicator

Value domain attributes

Representational attributes

Representation class:Help on this termCode
Data type:Help on this termNumber
Format:Help on this termN
Maximum character length:Help on this term1
Permissible values:Help on this term
Supplementary values:Help on this term
9Not stated/inadequately described

Collection and usage attributes

Guide for use:Help on this term

CODE 9    Not stated/inadequately described

This code is not for use in primary data collections.

Data element attributes

Collection and usage attributes

Guide for use:Help on this term

CODE 1   Yes
Record if peripheral neuropathy is present in the person.

CODE 2   No
Record if peripheral neuropathy is not present in the person.

Record whether or not peripheral neuropathy is present determined by clinical judgement following assessment using pinprick and vibration (using perhaps a Biothesiometer) or Monofilament.

Collection methods:Help on this term

Examine for neuropathy by testing reflexes and sensation preferably using tuning fork (standard vibration fork 128 hz), pinprick, 10g monofilament and/or biothesiometer.

The preferred assessment methods are monofilament and biothesiometer. These two non-invasive tests provide more objective and repeatable results than testing sensation with pinprick or a tuning fork, which are very difficult to standardise.

1 The 'Touch-Test' Sensory Evaluation (Semmens-Weinstein Monofilaments) application guidelines:

  • Occlude the patient's vision by using a shield or by having the patient look away or close his or her eyes.
  • Instruct the patient to respond when a stimulus is felt by saying 'touch' or 'yes'.
  • Prepare to administer the stimulus to the foot (dorsal or plantar surface).
  • Press the filament of the Touch
  • Test at a 90 degree angle against the skin until it bows. Hold in place for approximately 1.5 seconds and then remove.

  To assure the validity of the sensory test findings:

  • The patient must not be able to view the administration of the stimuli so that false indications are avoided.
  • The nylon filament must be applied at a 90 degree angle against the skin until it bows for approximately 1.5 second before removing.
  • If the patient does not feel the filament, then protective pain sensation has been lost.

2 Testing vibration sensation with a biothesiometer - application guidelines:

  • The biothesiometer has readings from 0 to 50 volts. It can be made to vibrate at increasing intensity by turning a dial.
  • A probe is applied to part of the foot, usually on the big toe.
  • The person being tested indicates as soon as he/she can feel the vibration and the reading on the dial at that point is recorded.

The reading is low in young normal individuals (i.e. they are very sensitive to vibration). In older individuals, the biothesiometer reading becomes progressively higher. From experience, it is known that the risk of developing a neuropathic ulcer is much higher if a person has a biothesiometer reading greater than 30-40 volts.

Source and reference attributes

Submitting organisation:Help on this term

National Diabetes Data Working Group

Origin:Help on this term

National Diabetes Outcomes Quality Review Initiative (NDOQRIN) data dictionary

Reference documents:Help on this term

1997 North Coast Medical, INC. San Jose, CA 95125; 800 821 - 9319

Duffy MD, John C and Patout MD, Charles A. 1990. 'Management of the Insensitive Foot in Diabetes: Lessons from Hansen's Disease'. Military Medicine, 155:575-579

Bell- Krotovski OTR, FAOT, FAOTA, Judith and Elizabeth Tomancik LOTR. 1987.The Repeatability of testing with Semmens-Weinstein Monofilaments. 'The Journal of Hand Surgery,' 12A: 155 - 161

Edmonds M, Boulton A, Buckenham T, et al. Report of the Diabetic Foot and Amputation Group. Diabet Med 1996; 13: S27 - 42

Foot Examination -an interactive guide; Aust Prescr 2002; 25:8 - 10

Relational attributes

Related metadata references:Help on this term

Supersedes Person—peripheral neuropathy status, code N Health, Superseded 21/09/2005

Implementation in Data Set Specifications:Help on this term

Diabetes (clinical) NBPDS Health, Standard 21/09/2005

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