The American Academy of Neurology (AAN), the American Association of Neuromuscular and Electrodiagnostic Medicine (AANEM), and the American Academy of Physical Medicine and Rehabilitation (AAPM&R) recently convened a Polyneuropathy Task Force that was charged with the task of developing a case definition of distal symmetric polyneuropathy (DSP) with high sensitivity and specificity that could serve as the basis for future research studies. The proposed definition was based on a systematic analysis of peer-reviewed literature supplemented by a formal consensus process among experts in the field. The Task Force noted that there was a limited number of published articles relevant to their mission but that the quality of the available articles was high and that this allowed for development of a case definition for distal symmetric polyneuropathy. Although published simultaneously in Neurology, 7 Muscle & Nerve, 6 and Archives of Physical Medicine and Rehabilitation, 5 the official journals of the AAN, AANEM, and AAPM&R, the proposed case definition seems to have prompted very little if any public discussion.
The goal of developing a formal case definition for DSP is a laudable one, and the process of a combination of a systematic review of the literature and a formal consensus among recognized experts in the field seems appropriate. There are, however, several methodological issues that might call into question the legitimacy of the proposed case definition.