title: Impact of medical audit on electrodiagnostic medicine in polyneuropathy.
abstract: OBJECTIVE
  The aim of the study was to investigate whether experienced physicians' electrodiagnostic practice and criteria can be influenced by international collaboration involving peer review medical audit.
  
  
  METHODS
  Data was obtained from the ESTEEM project, an ongoing collaboration since 1991 among European neurophysiologists concerned with quality improvement in electrodiagnostic medicine. Three sets of the physicians' polyneuropathy examinations performed with intervals of 2-4 years were analysed.
  
  
  RESULTS
  Changes towards increased homogeneity among the physicians were found in (1) the average number of studies performed per patient and the number of abnormal studies required for accepting the diagnosis of polyneuropathy, with the most pronounced changes seen for abnormal motor nerve segments, abnormal F-wave studies, and electromyographic studies, and (2) the agreement on pathophysiological interpretation of nerve conduction studies and classification of polyneuropathy.
  
  
  CONCLUSIONS
  Changes towards increased homogeneity contributed to years of participation in peer review medical audit, were seen among a group of experienced physicians. Peer review medical audit as carried out here is however difficult to scale up. Therefore guidelines or minimal criteria should ideally supplement a medical audit process to disseminate the results obtained to a larger audience.
  
  
  CONCLUSIONS
  These results support the role of international peer review medical audit in quality improvement of electrodiagnostic medicine.
authors.affiliation: Department of Clinical Neurophysiology, Aarhus University Hospital, Aarhus, Denmark.
authors.forename: Kirsten
authors.initials: K
authors.lastname: Pugdahl
authors.forename: Anders
authors.initials: A
authors.lastname: Fuglsang-Frederiksen
authors.forename: Hatice
authors.initials: H
authors.lastname: Tankisi
authors.forename: Birger
authors.initials: B
authors.lastname: Johnsen
authors.forename: Mamede de
authors.initials: Md
authors.lastname: 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: Ian S
authors.initials: IS
authors.lastname: Schofield
mesh_terms: D004568:Electrodiagnosis / Q000379:methods* / Q000592:standards; D004576:Electromyography; D005260:Female; D006801:Humans; D008297:Male; D008485:Medical Audit; D009431:Neural Conduction / Q000502:physiology; D011115:Polyneuropathies / Q000175:diagnosis*; D058996:Quality Improvement / Q000592:standards