title: Electrodiagnostic consultation and identification of neuromuscular conditions in persons with diabetes.
abstract: BACKGROUND
  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.
authors: Center for Management of Complex Chronic Care, Hines VA Hospital, 5000 South 5th Avenue (151H), Hines, Illinois 60141, USA. msohn@northwestern.edu
authors: Min-Woong
authors: MW
authors: Sohn
authors: Jeff
authors: J
authors: Whittle
authors: Liliana E
authors: LE
authors: Pezzin
authors: Haiyan
authors: H
authors: Miao
authors: Timothy R
authors: TR
authors: Dillingham