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Electrodiagnostic consultation and identification of neuromuscular conditions in persons with diabetes
Author(s) -
Sohn MinWoong,
Whittle Jeff,
Pezzin Liliana E.,
Miao Haiyan,
Dillingham Timothy R.
Publication year - 2011
Publication title -
muscle and nerve
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.025
H-Index - 145
eISSN - 1097-4598
pISSN - 0148-639X
DOI - 10.1002/mus.22003
Subject(s) - medicine , electromyography , carpal tunnel syndrome , specialty , physical therapy , polyneuropathy , peripheral neuropathy , physical medicine and rehabilitation , electromyoneurography , ulnar neuropathy , medical diagnosis , diabetes mellitus , family medicine , ulnar nerve , surgery , pathology , elbow , endocrinology
: 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. Muscle Nerve, 2011