Evidence mapPaperPMID 34210657Full record

ArticleDiabetes care2021

Corneal Confocal Microscopy Predicts the Development of Diabetic Neuropathy: A Longitudinal Diagnostic Multinational Consortium Study.

Bruce A Perkins, Leif Erik Lovblom, Evan J H Lewis, Vera Bril, Maryam Ferdousi, Andrej Orszag, Katie Edwards, Nicola Pritchard, Anthony Russell, Cirous Dehghani and 12 more

Open access · bronzeAbstract read
In one paragraph

Article in Diabetes care, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 37 papers.

0numbers the graph read from it
0cells of the map it votes in
37citing papers in PubMed
7.3field-weighted citation impact, top 2% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

37 citing papers in PubMed, 48 citations in OpenAlex.

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  13. Cornea Nerves Can Identify Different Types of Parkinson's Disease.Investigative ophthalmology & visual science · 2025
    Article
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  19. Advances in diagnosis and management of distal sensory polyneuropathies.Journal of neurology, neurosurgery, and psychiatry · 2023
    Review
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

22 authors at 7 institutions in 5 countries.

Bruce A PerkinsLunenfeld-Tanenbaum Research Institute, Mount Sinai Hospital, Toronto, Ontario, Canada bruce.perkins@sinaihealth.ca.ORCID 0000-0002-5885-0046
Leif Erik LovblomLunenfeld-Tanenbaum Research Institute, Mount Sinai Hospital, Toronto, Ontario, Canada.ORCID 0000-0002-6774-8924
Evan J H LewisLunenfeld-Tanenbaum Research Institute, Mount Sinai Hospital, Toronto, Ontario, Canada.ORCID 0000-0002-4353-2969
Vera BrilThe Ellen and Martin Prosserman Centre for Neuromuscular Diseases, Krembil Neuroscience Centre, Division of Neurology, Department of Medicine, University Health Network, University of Toronto, Toronto, Ontario, Canada.ORCID 0000-0002-5805-4883
Maryam FerdousiUniversity of Manchester, Manchester, U.K.
Andrej OrszagLunenfeld-Tanenbaum Research Institute, Mount Sinai Hospital, Toronto, Ontario, Canada.
Katie EdwardsQueensland University of Technology, Brisbane, Queensland, Australia.
Nicola PritchardQueensland University of Technology, Brisbane, Queensland, Australia.
Anthony RussellUniversity of Queensland, Woolloongabba, Queensland, Australia.ORCID 0000-0003-4902-6693
Cirous DehghaniQueensland University of Technology, Brisbane, Queensland, Australia.
Danièle PacaudAlberta Children's Hospital, University of Calgary, Calgary, Alberta, Canada.
Kenneth RomanchukAlberta Children's Hospital, University of Calgary, Calgary, Alberta, Canada.
Jean K MahAlberta Children's Hospital, University of Calgary, Calgary, Alberta, Canada.
Maria JeziorskaUniversity of Manchester, Manchester, U.K.ORCID 0000-0002-3492-0177
Andrew MarshallAlberta Children's Hospital, University of Calgary, Calgary, Alberta, Canada.ORCID 0000-0001-8273-7089
Roni M ShteinUniversity of Michigan, Ann Arbor, MI.
Rodica Pop-BusuiUniversity of Michigan, Ann Arbor, MI.ORCID 0000-0002-2042-1350
Stephen I LentzUniversity of Michigan, Ann Arbor, MI.
Mitra TavakoliUniversity of Manchester, Manchester, U.K.ORCID 0000-0003-2319-1543
Andrew J M BoultonUniversity of Manchester, Manchester, U.K.
Nathan EfronQueensland University of Technology, Brisbane, Queensland, Australia.
Rayaz A MalikUniversity of Manchester, Manchester, U.K.ORCID 0000-0002-7188-8903
University of Manchester · GBMount Sinai Hospital · CAQueensland University of Technology · AUUniversity of Calgary · CAUniversity of Michigan · USThe University of Queensland · AUUniversity Health Network · CA

Funding

Pilot and Feasibility ProgramP30DK020572 · NIDDK · UNIVERSITY OF MICHIGAN AT ANN ARBOR · 2022 to 2025
$4.9M
NIDDK NIH HHS DP3 DK104386NIDDK NIH HHS P30 DK020572
6 · The paper itself

Abstract

objectiveCorneal nerve fiber length (CNFL) has been shown in research studies to identify diabetic peripheral neuropathy (DPN). In this longitudinal diagnostic study, we assessed the ability of CNFL to predict the development of DPN. RESEARCH DESIGN AND

methodsFrom a multinational cohort of 998 participants with type 1 and type 2 diabetes, we studied the subset of 261 participants who were free of DPN at baseline and completed at least 4 years of follow-up for incident DPN. The predictive validity of CNFL for the development of DPN was determined using time-dependent receiver operating characteristic (ROC) curves.

resultsA total of 203 participants had type 1 and 58 had type 2 diabetes. Mean follow-up time was 5.8 years (interquartile range 4.2-7.0). New-onset DPN occurred in 60 participants (23%; 4.29 events per 100 person-years). Participants who developed DPN were older and had a higher prevalence of type 2 diabetes, higher BMI, and longer duration of diabetes. The baseline electrophysiology and corneal confocal microscopy parameters were in the normal range but were all significantly lower in participants who developed DPN. The time-dependent area under the ROC curve for CNFL ranged between 0.61 and 0.69 for years 1-5 and was 0.80 at year 6. The optimal diagnostic threshold for a baseline CNFL of 14.1 mm/mm

conclusionsCNFL showed good predictive validity for identifying patients at higher risk of developing DPN ∼6 years in the future.

Indexed as

Diabetes Mellitus, Type 2Diabetic NeuropathiesCorneaHumansMicroscopy, ConfocalNerve Fibers

Identifiers

PMID34210657
PMCPMC8740920
OpenAlexW3177015039

What Socratic holds

Textmetadata
Read underepoch 390

Registered trials

None linked

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 Socratic graph.