Electrodiagnostic consultation and identification of neuromuscular conditions in persons with diabetes. Muscle Nerve 2011 Jun;43(6):812-7
Date
05/25/2011Pubmed ID
21607966DOI
10.1002/mus.22003Scopus ID
2-s2.0-79957952350 (requires institutional sign-in at Scopus site) 5 CitationsAbstract
INTRODUCTION: Although the American Association of Neuromuscular and Electrodiagnostic Medicine recommends that electrodiagnostic procedures should be performed by physicians with specialty training, these procedures are increasingly being performed by non-specialists.
METHODS: We used a nationally representative sample of Medicare beneficiaries with diabetes who used electrodiagnostic services in 2006 to examine whether specialists and non-specialists were different in the rates of identifying common neuromuscular conditions.
RESULTS: Specialists (neurologists and physiatrists) performed 62% of electrodiagnostic consultations; non-specialist physicians and non-physicians performed 31% and 5%, respectively. After adjusting for age, race/ethnicity, diabetes severity, and comorbidities, specialists were 1.26-9 times more likely than non-physicians to diagnose polyneuropathy, lumbosacral radiculopathy, cervical radiculopathy, carpal tunnel syndrome, and ulnar neuropathy. Almost 80% of electrodiagnostic studies performed by specialists included electromyography testing; fewer than 13% by non-specialists did.
CONCLUSIONS: Inadequate use of electromyography and fewer specific diagnoses suggest that many non-specialists perform insufficiently comprehensive electrodiagnostic studies.
Author List
Sohn MW, Whittle J, Pezzin LE, Miao H, Dillingham TRAuthors
Liliana Pezzin PhD, JD Professor in the Institute for Health and Equity department at Medical College of WisconsinJeffrey Whittle MD Professor in the Medicine department at Medical College of Wisconsin
MESH terms used to index this publication - Major topics in bold
AgedAged, 80 and over
Cohort Studies
Diabetic Neuropathies
Electrodiagnosis
Female
Humans
Male
Medicare
Medicine
Middle Aged
Neuromuscular Diseases
Predictive Value of Tests
Referral and Consultation
Severity of Illness Index
United States
