Compliance with electrodiagnostic guidelines for patients undergoing carpal tunnel release

摘要: Abstract Storm S, Beaver SK, Giardino N, Kliot M, Franklin GM, Jarvik JG, Chan L. Compliance with electrodiagnostic guidelines for patients undergoing carpal tunnel release. Objective To describe how clinical practice in those who underwent release (CTR) matched the American Association of Electrodiagnostic Medicine (AAEM) 1993 parameters evaluation syndrome (CTS). Design Cohort study using 1998–1999 Medicare billing data. Setting Washington State. Participants State beneficiaries CTR 1999 (N=1567) Interventions Not applicable. Main outcome measures AAEM parameters. Results Of 324 receiving surgery, 24 (20.7%) did not have any testing before surgery. One hundred seventy-one (10.9%) had performed that lead to diagnosis CTS. thousand seventy-two (68.4%) were diagnosed CTS through testing; 155 (9.9%) less than 2 sensory nerves studied, 114 (7.3%) motor and 65 (4.2%) studies met neither standard (sensory nerve testing) nor guideline (motor testing). In a multivariate analysis, neurologists more likely physiatrists meet standards (adjusted relative risk [adj RR]=1.61; 95% confidence interval [CI], 1.13–2.31) living rural areas no or inadequate (adj RR=1.6; CI, 1.3–1.9). Conclusions Over one third may an inappropriate workup Policymakers should consider mandating appropriate test approving CTR.