Title of article :
Influence of peer review medical audit on pathophysiological interpretation of nerve conduction studies in polyneuropathies
Author/Authors :
Hatice Tankisi، نويسنده , , Kirsten Pugdahl، نويسنده , , Anders Fuglsang-Frederiksen، نويسنده , , Birger Johnsen، نويسنده , , Mamede de Carvalho، نويسنده , , Peter R.W. Fawcett، نويسنده , , Annick Labarre-Vila، نويسنده , , Rocco Liguori، نويسنده , , Wilfred A. Nix، نويسنده , , Mette L. Olsen، نويسنده , , Ian S. Schofield، نويسنده ,
Issue Information :
روزنامه با شماره پیاپی سال 2006
Pages :
5
From page :
979
To page :
983
Abstract :
Objective To evaluate the possible influence of peer review medical audit on experienced physiciansʹ pathophysiological interpretation of nerve conduction studies in polyneuropathy patients. Methods Since 1992, 7 European neurophysiologists have collected samples of their patient examinations for regular review where the physicians interpret each otherʹs cases electronically and subsequently discuss them at regular workshop meetings (i.e. a form of medical audit). Two sets of 100 polyneuropathy examinations interpreted with an interval of 4–6 years were selected. The sets contained 1456 and 1719 nerve conduction studies, each given a pathophysiological test conclusion by each individual physician. Inter-physician agreement on interpretation of demyelination and axonal loss of the nerve, as well as neuropathic and unspecific findings, was estimated using kappa statistics. Results Increased agreement from set 1 to set 2 was found on interpretation of demyelination of the nerve (set 1: κ=0.22; set 2: κ=0.45), and of neuropathic (set 1: κ=0.46; set 2: κ=0.64) and unspecific findings (set 1: κ=0.35; set 2: κ=0.54). No changes were found on interpretation of axonal loss (set 1: κ=0.26; set 2: κ=0.31) and normal findings (set 1 and set 2: κ=0.90). Conclusions Participation in regular peer review medical audit resulted in increased agreement on interpretation of nerve conduction studies for 6 of the 7 participants. The study further highlights the need for better definition of criteria for identification of demyelinating, and in particular, axonal peripheral neuropathies. Significance International collaboration involving peer review medical audit may contribute to development of practice guidelines and, in turn, to increased quality of electrodiagnostic medicine.
Keywords :
Multicentre database , Peer review medical audit , Nerve pathophysiology , Polyneuropathy , Nerve conduction studies
Journal title :
Clinical Neurophysiology
Serial Year :
2006
Journal title :
Clinical Neurophysiology
Record number :
523566
Link To Document :
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