{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,28]],"date-time":"2026-07-28T04:59:59Z","timestamp":1785214799485,"version":"3.55.0"},"reference-count":18,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,7,28]],"date-time":"2026-07-28T00:00:00Z","timestamp":1785196800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Neurol."],"abstract":"\n Introduction<\/jats:title>\n \n Diabetic Peripheral Neuropathy (DPN) is associated with pain and increased risk of foot ulceration and lower-limb amputation. Most people remain undiagnosed due to the lack of a simple, rapid, and reliable screening tool suitable for primary care. We evaluated the reproducibility of a short, self-administered screening tool (ACT) for DPN compared with the Michigan Neuropathy Screening Instrument Questionnaire (MNSI\n q<\/jats:sub>\n ) and examination (MNSI\n e<\/jats:sub>\n ).\n <\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n \n In this observational study, 126 adults with type 1 or type 2 diabetes were recruited from an outpatient endocrinology clinic. Participants completed the ACT\n questionnaire (q) + examination (e)<\/jats:sub>\n which can be summed to create a total\n q + e<\/jats:sub>\n score of 0\u201320, and MNSI\n q + e<\/jats:sub>\n at baseline and after 14 days. Reproducibility was assessed using intraclass correlation coefficients (ICC) for continuous scores and Cohen\u2019s kappa (\n \u03ba<\/jats:italic>\n ) for categorical reproducibility.\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n ACT\n q + e<\/jats:sub>\n demonstrated good reproducibility with an ICC = 0.85 (ICC = 0.78 for ACT\n q<\/jats:sub>\n ; ICC = 0.88 for ACT\n e<\/jats:sub>\n ) which was comparable to ICC = 0.82 for MNSI\n q<\/jats:sub>\n ; ICC = 0.75 for MNSI\n e<\/jats:sub>\n ; ICC = 0.85 for MNSI\n q + e<\/jats:sub>\n . Dichotomized classification of the overall ACT showed strong repeatability with \u03ba = 0.83 (\n \u03ba<\/jats:italic>\n = 0.61 ACT\n q<\/jats:sub>\n and moderate-to-strong repeatability for ACT\n e<\/jats:sub>\n with\n \u03ba<\/jats:italic>\n = 0.78). Symptoms showed variable agreement, with the strongest reproducibility for burning and pins-and-needles sensations. The sensory examination components of ACT\n e<\/jats:sub>\n demonstrated strong agreement (\n \u03ba<\/jats:italic>\n = 0.81).\n <\/jats:p>\n <\/jats:sec>\n \n Discussion<\/jats:title>\n \n The overall ACT tool demonstrated good 14-day reproducibility compared to the overall MNSI\n q + e<\/jats:sub>\n . The brevity, self-administered format, and minimal reliance on clinician expertise, support the utility of ACT as a practical screening instrument for DPN in busy, resource-limited clinical settings.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.3389\/fneur.2026.1847401","type":"journal-article","created":{"date-parts":[[2026,7,28]],"date-time":"2026-07-28T04:25:30Z","timestamp":1785212730000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Reproducibility of ACT, A simple-self-administered sCreening Tool for diabetic peripheral neuropathy"],"prefix":"10.3389","volume":"17","author":[{"given":"Hoda","family":"Gad","sequence":"first","affiliation":[{"name":"Lunenfeld-Tanenbaum Research Institute, Mount Sinai Hospital","place":["Toronto, ON, Canada"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Einas","family":"Elgassim","sequence":"additional","affiliation":[{"name":"Research Department, Weill Cornell Medicine-Qatar","place":["Doha, Qatar"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Srividya","family":"Bennabhaktula","sequence":"additional","affiliation":[{"name":"Research Department, Weill Cornell Medicine-Qatar","place":["Doha, Qatar"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Areej","family":"Baraka","sequence":"additional","affiliation":[{"name":"Research Department, Weill Cornell Medicine-Qatar","place":["Doha, Qatar"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Khaled","family":"Baagar","sequence":"additional","affiliation":[{"name":"Endocrinology Department, Hamad Medical Corporation","place":["Doha, Qatar"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrej","family":"Orszag","sequence":"additional","affiliation":[{"name":"Lunenfeld-Tanenbaum Research Institute, Mount Sinai Hospital","place":["Toronto, ON, Canada"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leif Erik","family":"Lovblom","sequence":"additional","affiliation":[{"name":"Institute of Health Policy, Management and Evaluation, University of Toronto","place":["Toronto, ON, Canada"]},{"name":"Biostatistics Department, University Health Network","place":["Toronto, ON, Canada"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bruce A.","family":"Perkins","sequence":"additional","affiliation":[{"name":"Lunenfeld-Tanenbaum Research Institute, Mount Sinai Hospital","place":["Toronto, ON, Canada"]},{"name":"Institute of Health Policy, Management and Evaluation, University of Toronto","place":["Toronto, ON, Canada"]},{"name":"Department of Medicine, Division of Endocrinology, University of Toronto","place":["Toronto, ON, Canada"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rayaz A.","family":"Malik","sequence":"additional","affiliation":[{"name":"Research Department, Weill Cornell Medicine-Qatar","place":["Doha, Qatar"]},{"name":"Institute of Cardiovascular Medicine, University of Manchester","place":["Manchester, United Kingdom"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,7,28]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"136","DOI":"10.2337\/dc16-2042","article-title":"Diabetic neuropathy: a position statement by the American Diabetes Association","volume":"40","author":"Pop-Busui","year":"2017","journal-title":"Diabetes Care"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"113103","DOI":"10.1016\/j.diabres.2026.113103","article-title":"Global prevalence of diabetes-related neuropathy and vascular complications: a systematic review and meta-analysis","volume":"232","author":"Burhan","year":"2026","journal-title":"Diabetes Res Clin Pract"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"1380929","DOI":"10.3389\/fendo.2024.1380929","article-title":"Expert opinion on screening, diagnosis and management of diabetic peripheral neuropathy: a multidisciplinary approach","volume":"15","author":"Atmaca","year":"2024","journal-title":"Front Endocrinol (Lausanne)"},{"key":"ref4","doi-asserted-by":"publisher","DOI":"10.4081\/jphr.2022.2752","article-title":"Early detection to prevent foot ulceration among type 2 diabetes mellitus patient: a multi-intervention review","volume":"11","author":"Rismayanti","year":"2022","journal-title":"J Public Health Res"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"5902036","DOI":"10.1155\/jdr\/5902036","article-title":"Diagnostic accuracy of screening tests for diabetic peripheral neuropathy: an umbrella review","volume":"2024","author":"Mogilevskaya","year":"2024","journal-title":"J Diabetes Res"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"28","DOI":"10.1111\/jns.12613","article-title":"Earlier diagnosis of peripheral neuropathy in primary care: a call to action","volume":"29","author":"Gad","year":"2024","journal-title":"J Peripher Nerv 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Neurosurg"},{"key":"ref13","doi-asserted-by":"publisher","first-page":"2048","DOI":"10.2337\/diacare.25.11.2048","article-title":"Validation of the Toronto clinical scoring system for diabetic polyneuropathy","volume":"25","author":"Bril","year":"2002","journal-title":"Diabetes Care"},{"key":"ref14","doi-asserted-by":"publisher","first-page":"1115","DOI":"10.1212\/WNL.45.6.1115","article-title":"Variables influencing neuropathic endpoints: the Rochester diabetic neuropathy study of healthy subjects","volume":"45","author":"Dyck","year":"1995","journal-title":"Neurology"},{"key":"ref15","doi-asserted-by":"publisher","first-page":"2285","DOI":"10.2337\/dc10-1303","article-title":"Diabetic neuropathies: update on definitions, diagnostic criteria, estimation of severity, and treatments","volume":"33","author":"Tesfaye","year":"2010","journal-title":"Diabetes Care"},{"key":"ref16","doi-asserted-by":"publisher","first-page":"42","DOI":"10.1038\/s41572-019-0097-9","article-title":"Diabetic 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Neurology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fneur.2026.1847401\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,28]],"date-time":"2026-07-28T04:25:31Z","timestamp":1785212731000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fneur.2026.1847401\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,28]]},"references-count":18,"alternative-id":["10.3389\/fneur.2026.1847401"],"URL":"https:\/\/doi.org\/10.3389\/fneur.2026.1847401","relation":{},"ISSN":["1664-2295"],"issn-type":[{"value":"1664-2295","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,28]]},"article-number":"1847401"}}