title: Variation in the classification of polyneuropathies among European physicians.
abstract: OBJECTIVE
  Considerable debate still exists regarding the classification of polyneuropathies (PNPs) into predominantly demyelinating, predominantly axonal loss, mixed or unclassified. This study was designed to determine the variation among physicians in the classification of PNPs by using the European Standardized Telematic tool to Evaluate Electromyography knowledge-based systems and Methods (ESTEEM) multicenter database.
  
  
  METHODS
  Seven physicians from 6 laboratories in Europe sent a total of 156 prospectively collected cases of PNP with electromyography (EMG) data including diagnosis (examination diagnosis) to the database. Each physician interpreted the electrophysiological data from all cases (interpretation diagnosis) and a final diagnosis was given at the consensus meetings of the group (consensus diagnosis).
  
  
  RESULTS
  Comparison of each physician's examination diagnosis with his/her interpretation diagnosis, i.e. intra-physician variation, showed a change towards less classified PNPs (P < 0.05). Interpretation diagnoses showed large inter-physician variation in the classification of PNPs. The consensus group was more cautious than individual physicians in classifying PNPs as mixed and axonal. The probability of the consensus diagnosis increased with increasing number of abnormal motor and sensory segments tested.
  
  
  CONCLUSIONS
  Recognition of variation in classification of PNP as shown in this study and suggesting standards of good clinical practice developed by a consensus group may increase the quality of EMG practice.
authors.affiliation: Department of Clinical Neurophysiology, Aarhus University Hospital, AKH. Nørrebrogade 44, 8000, Aarhus, Denmark.
authors.forename: H
authors.initials: H
authors.lastname: Tankisi
authors.forename: B
authors.initials: B
authors.lastname: Johnsen
authors.forename: A
authors.initials: A
authors.lastname: Fuglsang-Frederiksen
authors.forename: M
authors.initials: M
authors.lastname: de Carvalho
authors.forename: P R W
authors.initials: PR
authors.lastname: Fawcett
authors.forename: A
authors.initials: A
authors.lastname: Labarre-Vila
authors.forename: R
authors.initials: R
authors.lastname: Liguori
authors.forename: W
authors.initials: W
authors.lastname: Nix
authors.forename: M
authors.initials: M
authors.lastname: Olsen
authors.forename: I
authors.initials: I
authors.lastname: Schofield
mesh_terms: D032921:Consensus; D016208:Databases, Factual; D003711:Demyelinating Diseases / Q000145:classification / Q000175:diagnosis; D004576:Electromyography / Q000592:standards; D005060:Europe; D015417:Hereditary Sensory and Motor Neuropathy / Q000145:classification / Q000175:diagnosis; D006801:Humans; D009431:Neural Conduction; D009462:Neurology / Q000592:standards / Q000706:statistics & numerical data*; D015588:Observer Variation; D010380:Peer Review; D011115:Polyneuropathies / Q000145:classification* / Q000175:diagnosis*; D012678:Sensation Disorders / Q000145:classification / Q000175:diagnosis