Person—peripheral neuropathy indicator, code N
Data Element Attributes
Identifying and definitional attributes | |
Metadata item type: | Data Element |
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Short name: | Peripheral neuropathy (status) |
METEOR identifier: | 302457 |
Registration status: | Health!, Standard 21/09/2005 |
Definition: | Whether peripheral neuropathy is present, as represented by a code. |
Data element concept attributes | |
Identifying and definitional attributes | |
Data element concept: | Person—peripheral neuropathy indicator |
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METEOR identifier: | 269622 |
Registration status: | Health!, Standard 01/03/2005 |
Definition: | The outcome of assessment for the presence of peripheral neuropathy. |
Context: | Public health, health care and clinical settings. |
Object class: | Person |
Property: | Peripheral neuropathy indicator |
Value domain attributes | |
Identifying and definitional attributes | |
Value domain: | Yes/no/not stated/inadequately described code N |
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METEOR identifier: | 301747 |
Registration status: | Health!, Standard 21/09/2005 Housing assistance, Standard 10/02/2006 Community Services (retired), Standard 14/02/2006 Early Childhood, Standard 21/05/2010 Homelessness, Standard 23/08/2010 Independent Hospital Pricing Authority, Standard 01/11/2012 Disability, Standard 07/10/2014 Indigenous, Standard 13/03/2015 Children and Families, Standard 22/11/2016 |
Definition: | A code set representing 'yes', 'no' and 'not stated/inadequately described'. |
Representational attributes | ||
Representation class: | Code | |
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Data type: | Number | |
Format: | N | |
Maximum character length: | 1 | |
Value | Meaning | |
Permissible values: | 1 | Yes |
2 | No | |
Supplementary values: | 9 | Not stated/inadequately described |
Collection and usage attributes | |
Guide for use: | CODE 9 Not stated/inadequately described This code is not for use in primary data collections. |
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Data element attributes | |
Collection and usage attributes | |
Guide for use: | CODE 1 Yes CODE 2 No Record whether or not peripheral neuropathy is present determined by clinical judgement following assessment using pinprick and vibration (using perhaps a Biothesiometer) 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 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:
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 |
Reference documents: | 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: | Supersedes Person—peripheral neuropathy status, code N Health!, Superseded 21/09/2005 |
Implementation in Data Set Specifications: | Diabetes (clinical) NBPDS Health!, Standard 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. |