医疗评价对多发性神经病电诊断评估的影响:一项多中心研究  

Influence of medical audit on electrodiagnostic evaluation of polyneuropathy. A multicentre study

作　　者：Pugdahl K. Tankisi H. Fuglsang-Frederiksen A. 郭俊 

机构地区：[1]Dept. of Clinical Neurophysiology,Aarhus University Hospital, Building 10, Nφrrebrogade 44,8000 Aarhus C, Denmark

出　　处：《世界核心医学期刊文摘（神经病学分册）》2005年第8期23-24,共2页Digest of the World Core Medical Journals:Clinical Neurology

摘　　要：Objective: Since 1992, 7 European neurophysiologists have participated in the ESTEEM project concerned with improvements in electrodiagnostic medicine. This s tudy assesses whether the collaboration that includes peer review medicalaudit h as influenced the involved physicians’electrodiagnostic criteria for polyneurop athy (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 fo r diagnosing PNP, and (2) agreement between the classifications given by the ind ividual physicians and the peer review group. Results: The average number of abn ormal motor nerve segments per patient increased from 4.6 to 6.4 during the stud y. Although most individual changes were minor,the second set of examinations sh owed an increased homogeneity among the physicians in the number of abnormal motor nerve segment s and abnormal F wave studies, and a tendency towards increased homogeneity in t he number of abnormal sensory nerve segments. There was also an increased agreem enton pathophysiological PNP classification in the second set of examinations co mpared to the first set. Conclusions: The participation in the ESTEEM project se ems to have impacted the physicians’clinical routine, possibly as they have acc ustomed themselves to apply criteria more strictly. Significance: This study sup port that international collaboration is a useful step towards improvements in e lectrodiagnostic medicine.Objective: Since 1992, 7 European neurophysiologists have participated in the ESTEEM project concerned with improvements in electrodiagnostic medicine. This s tudy assesses whether the collaboration that includes peer review medicalaudit h as influenced the involved physicians'electrodiagnostic criteria for polyneurop athy (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 fo r diagnosing PNP, and (2) agreement between the classifications given by the ind ividual physicians and the peer review group. Results: The average number of abn ormal motor nerve segments per patient increased from 4.6 to 6.4 during the stud y. Although most individual changes were minor,the second set of examinations sh owed an increased homogeneity among the physicians in the number of abnormal motor nerve segment s and abnormal F wave studies, and a tendency towards increased homogeneity in t he number of abnormal sensory nerve segments. There was also an increased agreem enton pathophysiological PNP classification in the second set of examinations co mpared to the first set. Conclusions: The participation in the ESTEEM project se ems to have impacted the physicians'clinical routine, possibly as they have acc ustomed themselves to apply criteria more strictly. Significance: This study sup port that international collaboration is a useful step towards improvements in e lectrodiagnostic medicine.

关 键 词：多发性神经病 医疗评价 诊断评估 电诊断医学 神经生理学 同行评审 电生理 病理生理 诊断标准 相关学科 

分 类 号：R744.51[医药卫生—神经病学与精神病学]