ArticleArchives of neurology2012
The evaluation of distal symmetric polyneuropathy: a physician survey of clinical practice.
Article in Archives of neurology, 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
12 citing papers in PubMed.
- A call to action for peripheral neuropathy research funding-Time to consolidate funding under one NIH initiative?Journal of the peripheral nervous system : JPNS · 2025Article
- Knowledge gaps in diagnosing chronic polyneuropathy: Review of national guidelines.Journal of the peripheral nervous system : JPNS · 2024Review
- Sensory-Motor Mechanisms Increasing Falls Risk in Diabetic Peripheral Neuropathy.Medicina (Kaunas, Lithuania) · 2021Review
- Effects of omega-3 polyunsaturated fatty-acid supplementation on neuropathic pain symptoms and sphingosine levels in Mexican-Americans with type 2 diabetes.Diabetes, metabolic syndrome and obesity : targets and therapy · 2019Article
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- Article
- Distal Symmetric Polyneuropathy: A Review.JAMA · 2015Review
- Headache neuroimaging: Routine testing when guidelines recommend against them.Cephalalgia : an international journal of headache · 2015Article
- Role of neurologists and diagnostic tests on the management of distal symmetric polyneuropathy.JAMA neurology · 2014Article
- Expenditures in the elderly with peripheral neuropathy: Where should we focus cost-control efforts?Neurology. Clinical practice · 2013Article
- Acquired neuropathies.Journal of neurology · 2013Review
- Value of thyroid and rheumatologic studies in the evaluation of peripheral neuropathy.Neurology. Clinical practice · 2013Article
Corrections and comments
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Authors and funding
5 authors.
Funding
Abstract
objectiveTo define current clinical practice for evaluating distal symmetric polyneuropathy.
designUsing a modified Dillman method, we sent surveys to 600 internists, 600 neurologists, and 45 neuromuscular specialists selected from the American Medical Association Physician Masterfile. Survey questions pertained to which tests providers would order in the following 3 scenarios: (1) the initial evaluation of distal symmetric polyneuropathy, (2) the use of additional tests if the initial evaluation was unrevealing, and (3) patients with diabetes. The t test was used to compare the number of tests ordered by physician type, and the χ(2) test was used to compare proportions of tests ordered.
settingNational survey of physicians.
participantsInternists, neurologists, and neuromuscular specialists.
resultsThe response rate was 35%. Overall, many tests were ordered for the full evaluation of distal symmetric polyneuropathy (mean [SD], 16.5 [7.2] tests), and there was substantial variation within and between provider types. Internists ordered fewer tests (mean [SD], 14.5 [6.1] tests) than did neurologists (mean [SD], 17.5 [7.9] tests) (P < .001). Regarding the glucose tolerance test, substantial differences were found between physician types, with neurologists and neuromuscular specialists ordering this test more frequently (28.6% and 72.3%, respectively) and internists ordering it less frequently (4.1%). A brain and/or spine magnetic resonance imaging scan was ordered by 19.8% of internists and 12.9% of neurologists.
conclusionsFrom the supporting evidence, current practice intent on evaluating distal symmetric polyneuropathy is highly variable and differs widely. For this disorder of the peripheral nerves, a high-yield test such as the glucose tolerance test is rarely used, whereas magnetic resonance imaging is likely overused. Research that defines the optimal evaluation of distal symmetric polyneuropathy has the potential to result in more efficient care.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.