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Impact of medical audit on electrodiagnostic medicine in polyneuropathy

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

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Abstract

Objective: The aim of the study was to investigate whether experienced physicians' electrodiagnostic practice and criteria can be influenced by international collaboration involving peer review medical audit. Methods: Data was obtained from the ESTEEM project, an ongoing collaboration since 1991 among European neurophysiologists concerned with quality improvement in electrodiagnostic medicine. Three sets of the physicians' polyneuropathy examinations performed with intervals of 2-4 years were analysed. Results: Changes towards increased homogeneity among the physicians were found in (1) the average number of studies performed per patient and the number of abnormal studies required for accepting the diagnosis of polyneuropathy, with the most pronounced changes seen for abnormal motor nerve segments, abnormal F-wave studies, and electromyographic studies, and (2) the agreement on pathophysiological interpretation of nerve conduction studies and classification of polyneuropathy. Conclusions: Changes towards increased homogeneity contributed to years of participation in peer review medical audit, were seen among a group of experienced physicians. Peer review medical audit as carried out here is however difficult to scale up. Therefore guidelines or minimal criteria should ideally supplement a medical audit process to disseminate the results obtained to a larger audience. Significance: These results support the role of international peer review medical audit in quality improvement of electrodiagnostic medicine. (C) 2011 International Federation of Clinical Neurophysiology. Published by Elsevier Ireland Ltd. All rights reserved.

Publication metadata

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

Publication type: Article

Publication status: Published

Journal: Clinical Neurophysiology

Year: 2011

Volume: 122

Issue: 12

Pages: 2523-2529

Print publication date: 23/06/2011

ISSN (print): 1388-2457

ISSN (electronic): 1872-8952

Publisher: Elsevier Ireland Ltd

URL: http://dx.doi.org/10.1016/j.clinph.2011.05.018

DOI: 10.1016/j.clinph.2011.05.018

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