Use of the AAEM guidelines in electrodiagnosis of ulnar neuropathy at the elbow.
OBJECTIVE
The goal of this study was to determine if practice patterns in Washington State were altered by the development and publication of the American Association of Electrodiagnostic Medicine practice parameter for electrodiagnosis of ulnar neuropathy at the elbow.


METHODS
Medical records from 350 workers' compensation patients who underwent surgery for ulnar neuropathy at the elbow in Washington State were reviewed for the consistency of the electrodiagnosticians' report and the practice parameter. Statistical analysis (chi2 or Fischer's exact test) compared prepublication and postpublication patterns of test use.


RESULTS
Thirty-one percent of the 153 studies (n = 47) were not consistent with American Association of Electrodiagnostic Medicine guidelines before its publication vs. 34% of the 138 studies (n = 47) after publication. This was not a statistically significant change (P = 0.63).


CONCLUSIONS
Evaluation of the usefulness and dissemination of the guidelines is warranted. The practice parameter may need to be simplified and educational efforts extended to improve provider use of new guidelines.
Thibault
Melissa W
MW
Department of Rehabilitation Medicine, University of Washington, Seattle, Washington, USA.
Robinson
Lawrence R
LR
Franklin
Gary
G
Fulton-Kehoe
Deborah
D
D000328:Adult; D004550:Elbow / Q000294:innervation*; D004568:Electrodiagnosis / Q000592:standards*; D005260:Female; D019983:Guideline Adherence / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D012955:Societies, Medical; D020424:Ulnar Neuropathies / Q000175:diagnosis* / Q000601:surgery; D014861:Washington; D014942:Workers' Compensation