From Bench to Bedside: Evaluating the Accuracy of Clinical Sensory Testing in Detecting Somatosensory Disorders. A Systematic Review
Federico Rossi, Ilaria Prato, Marco Mondelli, Danilo Rosafio, Chiara Cricco, Leonardo Pellicciari, Giuseppe Giovannico, Fabrizio Brindisino, Matteo CioetaABSTRACT
Background and Objective
To evaluate the Clinical Sensory Testing (CSTs) sensitivity and specificity in detecting somatosensory disorders across different populations.
Databases and Data Treatment
A systematic search on Medline (PubMed), Cochrane Library, CINAHL, EMBASE and Scopus was performed until August 2025. Eligible studies assessed CSTs in patients with somatosensory dysfunction by comparing them with any reference standard. Two reviewers independently screened studies, extracted data, and assessed risk of bias (RoB) using QUADAS‐2. Results were synthesised narratively and divided by sensory modality.
Results
Twelve studies ( N = 4911) were included, covering different conditions (e.g., diabetic peripheral neuropathy, lumbar spinal stenosis, neuropathic pain). CSTs demonstrated moderate to high specificity, particularly in pressure, mechanical, and vibration domains, while sensitivity varied widely by tool and modality. The Semmes‐Weinstein Monofilament Test showed 77%–90.7% sensitivity and 63.8%–100% specificity; tuning fork vibration tests ranged from 30% to 96% sensitivity and 45%–99% specificity. Thermal tests exhibited the greatest accuracy variability (sensitivity = 0.0%–97.1%; specificity = 2.0%–94.4%). Composite tools yielded the highest accuracy, with sensitivity/specificity often exceeding 87%. RoB was high or unclear in at least one QUADAS‐2 domain for the majority studies.
Conclusion
CSTs are pragmatic for preliminary somatosensory profiling, particularly in multimodal approaches. However, both sensitivity/specificity intervals and methodological heterogeneity limit their stand‐alone diagnostic use and warrant further investigations. Protocol standardisation and further validation against robust reference standards are needed to integrate CSTs into clinical diagnostics routines and to enhance their use as a reliable tool both in clinical and research.