Center for Management of Complex Chronic Care, Hines VA Hospital, 5000 South 5th Avenue (151H), Hines, Illinois 60141, USA.
Muscle Nerve. 2011 Jun;43(6):812-7. doi: 10.1002/mus.22003.
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.
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.
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.
Inadequate use of electromyography and fewer specific diagnoses suggest that many non-specialists perform insufficiently comprehensive electrodiagnostic studies.
尽管美国神经肌肉与电诊断医学协会建议电诊断程序应由具有专业培训的医生进行，但这些程序越来越多地由非专业人员执行。
我们使用了 2006 年医疗保险受益人的全国代表性样本，这些患者患有糖尿病并使用了电诊断服务，以检查专家和非专家在识别常见神经肌肉疾病的比率上是否存在差异。
专家（神经科医生和物理治疗师）进行了 62%的电诊断咨询；非专家医生和非医生分别进行了 31%和 5%的电诊断。在调整了年龄、种族/民族、糖尿病严重程度和合并症后，专家诊断多发性神经病、腰骶神经根病、颈神经根病、腕管综合征和尺神经病变的可能性是非医生的 1.26-9 倍。专家进行的近 80%的电诊断研究包括肌电图检查；而非专家进行的肌电图检查则不到 13%。
肌电图的使用不足和较少的具体诊断表明，许多非专家进行的电诊断研究不够全面。
