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Influence of medical audit on electrodiagnostic evaluation of polyneuropathy. A multicentre study

Lookup NU author(s): Dr Peter Fawcett, Dr Ian Schofield

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Abstract

Objective: Since 1992, 7 European neurophysiologists have participated in the ESTEEM project concerned with improvements in electrodiagnostic medicine. This study assesses whether the collaboration that includes peer review medical audit has influenced the involved physicians' electrodiagnostic criteria for polyneuropathy (PNP) diagnosing and classification. Methods: Two sets of each physician's PNP examinations performed early and late in the study were examined for changes in (1) number of studies with abnormal electrophysiological findings required for diagnosing PNP, and (2) agreement between the classifications given by the individual physicians and the peer review group. Results: The average number of abnormal motor nerve segments per patient increased from 4.6 to 6.4 during the study. Although most individual changes were minor, the second set of examinations showed an increased homogeneity among the physicians in the number of abnormal motor nerve segments and abnormal F wave studies, and a tendency towards increased homogeneity in the number of abnormal sensory nerve segments. There was also an increased agreement on pathophysiological PNP classification in the second set of examinations compared to the first set. Conclusions: The participation in the ESTEEM project seems to have impacted the physicians' clinical routine, possibly as they have accustomed themselves to apply criteria more strictly. Significance: This study support that international collaboration is a useful step towards improvements in electrodiagnostic medicine. (C) 2004 International Federation of Clinical Neurophysiology. Published by Elsevier Ireland Ltd. All rights reserved.


Publication metadata

Author(s): Pugdahl K, Tankisi H, Fuglsang-Frederiksen A, Johnsen B, de Carvalho M, Fawcett PRW, Labarre-Vila A, Liguori R, Nix W, Olsen ML, Schofield IS

Publication type: Article

Publication status: Published

Journal: Clinical Neurophysiology

Year: 2005

Volume: 116

Issue: 1

Pages: 49-55

ISSN (print): 1388-2457

ISSN (electronic): 1872-8952

Publisher: Elsevier Ireland Ltd

URL: http://dx.doi.org/10.1016/j.clinph.2004.07.026

DOI: 10.1016/j.clinph.2004.07.026


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