title: Influence of medical audit on electrodiagnostic evaluation of polyneuropathy. A multicentre study.
abstract: OBJECTIVE
  Since 1992, 7 European neurophysiologists have participated in the ESTEEM project concerned with improvements in electrodiagnostic medicine. This study assesses whether the collaboration that includes peer review medical audit has influenced the involved physicians' electrodiagnostic criteria for polyneuropathy (PNP) diagnosing and classification.
  
  
  METHODS
  Two sets of each physician's PNP examinations performed early and late in the study were examined for changes in (1) number of studies with abnormal electrophysiological findings required for diagnosing PNP, and (2) agreement between the classifications given by the individual physicians and the peer review group.
  
  
  RESULTS
  The average number of abnormal motor nerve segments per patient increased from 4.6 to 6.4 during the study. Although most individual changes were minor, the second set of examinations showed an increased homogeneity among the physicians in the number of abnormal motor nerve segments and abnormal F wave studies, and a tendency towards increased homogeneity in the number of abnormal sensory nerve segments. There was also an increased agreement on pathophysiological PNP classification in the second set of examinations compared to the first set.
  
  
  CONCLUSIONS
  The participation in the ESTEEM project seems to have impacted the physicians' clinical routine, possibly as they have accustomed themselves to apply criteria more strictly.
  
  
  CONCLUSIONS
  This study support that international collaboration is a useful step towards improvements in electrodiagnostic medicine.
authors.affiliation: Department of Clinical Neurophysiology, Aarhus University Hospital, Nørrebrogade 44, Building 10, 8000 Aarhus C, Denmark.
authors.forename: Kirsten
authors.initials: K
authors.lastname: Pugdahl
authors.forename: Hatice
authors.initials: H
authors.lastname: Tankisi
authors.forename: Anders
authors.initials: A
authors.lastname: Fuglsang-Frederiksen
authors.forename: Birger
authors.initials: B
authors.lastname: Johnsen
authors.forename: Mamede
authors.initials: M
authors.lastname: de Carvalho
authors.forename: Peter R W
authors.initials: PR
authors.lastname: Fawcett
authors.forename: Annick
authors.initials: A
authors.lastname: Labarre-Vila
authors.forename: Rocco
authors.initials: R
authors.lastname: Liguori
authors.forename: Wilfred
authors.initials: W
authors.lastname: Nix
authors.forename: Mette L
authors.initials: ML
authors.lastname: Olsen
authors.forename: Ian S
authors.initials: IS
authors.lastname: Schofield
mesh_terms: D000704:Analysis of Variance; D032921:Consensus; D004568:Electrodiagnosis / Q000379:methods / Q000592:standards / Q000706:statistics & numerical data; D005069:Evaluation Studies as Topic; D005260:Female; D006801:Humans; D007391:International Cooperation; D008297:Male; D008485:Medical Audit / Q000379:methods / Q000706:statistics & numerical data*; D018482:Muscle, Skeletal / Q000503:physiopathology*; D009431:Neural Conduction / Q000502:physiology; D011115:Polyneuropathies / Q000175:diagnosis*