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Reproducibility of ACT, A simple-self-administered sCreening Tool for diabetic peripheral neuropathy
Hoda Gad1, Einas Elgassim2, Srividya Bennabhaktula2
1Lunenfeld-Tanenbaum Research Institute, Mount Sinai Hospital, Toronto, ON, Canada.
Frontiers in Neurology
|August 12, 2026
Summary
A new screening tool (ACT) shows good reproducibility for detecting diabetic peripheral neuropathy (DPN) in adults with diabetes. This simple, self-administered test is suitable for primary care settings.
Area of Science:
- Neurology
- Endocrinology
- Clinical Diagnostics
Background:
- Diabetic Peripheral Neuropathy (DPN) is a common complication of diabetes, leading to pain and increased risk of severe foot problems.
- Current diagnostic methods lack simplicity and speed, hindering early detection in primary care settings.
Purpose of the Study:
- To evaluate the reproducibility of a novel, self-administered screening tool (ACT) for DPN.
- To compare the ACT tool's performance against the established Michigan Neuropathy Screening Instrument (MNSI).
Main Methods:
- An observational study involving 126 adults with type 1 or type 2 diabetes.
- Participants completed the ACT and MNSI (questionnaire and examination components) at baseline and after 14 days.
- Reproducibility was assessed using intraclass correlation coefficients (ICC) and Cohen's kappa (κ).
Main Results:
- The overall ACT tool (ACTq + e) demonstrated good 14-day reproducibility (ICC = 0.85), comparable to the MNSIq + e (ICC = 0.85).
- Dichotomized classification of the ACT showed strong repeatability (κ = 0.83).
- Specific components like sensory examination (κ = 0.81) and symptoms like burning and pins-and-needles showed strong agreement.
Conclusions:
- The ACT tool exhibits good 14-day reproducibility for DPN screening.
- Its self-administered nature and minimal reliance on clinician expertise make it a practical option for busy, resource-limited primary care settings.
