Diagnostic accuracy of the VibraTip in detection of diabetic peripheral neuropathy


  • Hisham Nizar Beta Cell Diabetes Centre, Chelsea & Westminster Hospital, London, UK. Diabetes Therapy Evaluation Network, London, UK. CSRI, Warwick University, Warwick
  • Neil Munro Beta Cell Diabetes Centre, Chelsea & Westminster Hospital, London, UK.
  • Peter Nightingale University Hospital Birmingham NHS Foundation Trust, Wellcome Trust Clinical Research Facility, Birmingham, United Kingdom
  • Michael D Fehrer Beta Cell Diabetes Centre, Chelsea & Westminster Hospital, London, UK. 2 Diabetes Therapy Evaluation Network, London, UK. 3 CSRI, Warwick University, Warwick





Clinical assessment of peripheral neuropathy can be  performed by testing vibration sense using a tuning fork and cutaneous sensation using a 10g Monofilament. The VibraTip® is a novel device which produces a constant  vibratory stimulus and therefore assesses vibration sense. This study wa  evaluated the diagnostic accuracy of the VibraTip compared to the tuning fork.


From 100 patients with diabetes, 50 patients had  confirmed peripheral neuropathy (PN +ve) and 50 were confirmed to have no peripheral neuropathy (PN -ve) as assessed by neurothesiometer. Both groups were then assessed using both the VibraTip and tuning fork.  The sensitivity, specificity, predictive values and likelihood  ratios for diagnosing peripheral neuropathy were  calculated. 


A statistically significant difference in sensitivity (52%)(P<0.001) between the VibraTip and tuning fork  results was observed for subjects +ve for peripheral  neuropathy. However no statistically significant  difference  in specificity (6%)(P<0.25) was seen for  subjects –ve for peripheral neuropathy.


This study confirms that the VibraTip is comparable to the neurothesiometer, and superior to the tuning fork, in the  detection of peripheral neuropathy and could be a useful screening tool in clinical practice


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