Person—peripheral neuropathy status, code N
Data Element Attributes
Identifying and definitional attributes | |
Metadata item type: | Data Element |
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Short name: | Peripheral neuropathy - status |
Synonymous names: | Peripheral neuropathy - status |
METEOR identifier: | 270161 |
Registration status: | Health!, Superseded 21/09/2005 |
Data Element Concept: | Person—peripheral neuropathy indicator |
Value Domain: | Peripheral neuropathy status code N |
Data element attributes | |
Collection and usage attributes | |
Guide for use: | Record whether or not peripheral neuropathy is present determined by clinical judgement following assessment using pinprick and vibration (using perhaps a Biosthesiometer) or Monofilament. |
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Collection methods: | 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 biosthesiometer. 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:
To assure the validity of the sensory test findings:
2 Testing vibration sensation with a biothesiometer - application guidelines:
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: | National diabetes data working group |
Origin: | National Diabetes Outcomes Quality Review Initiative (NDOQRIN) data dictionary |
Relational attributes | |
Related metadata references: | Has been superseded by Person—peripheral neuropathy indicator, code N Health!, Standard 21/09/2005 Is re-engineered from Peripheral neuropathy - status, version 1, DE, NHDD, NHIMG, Superseded 01/03/2005.pdf (22.2 KB) No registration status |
Implementation in Data Set Specifications: | Diabetes (clinical) DSS Health!, Superseded 21/09/2005 DSS specific information: The most important aspect of grading diabetic neuropathy from a foot ulceration point of view is to assess the degree of loss of sensation in the feet. Diabetic neuropathy tends to occur in the setting of long-standing hyperglycaemia. As stated by Duffy and others, the rate of lower extremity amputations can be reduced by 50% by the institution of monofilament testing in a preventive care program. Diabetes polyneuropathy is frequently asymptomatic but may be associated with numbness, tingling and paraesthesia in the extremities, and less often with hyperesthesias. The most common form is a distal, symmetric, predominantly sensory polyneuropathy, which begins and is usually most marked in the feet and legs. Peripheral nerve function should be checked at least yearly in the patient with diabetes. References: 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 |