Muscle Nerve. 2015 Apr;51(4):617-9. doi: 10.1002/mus.24628.
To discuss the American Association of Neuromuscular & Electrodiagnostic Medicine (AANEM)'s Top Five Recommendations in the Choosing Wisely campaign educating physicians and patients on high quality electrodiagnostic and neuromuscular medicine. The AANEM published its Top Five Recommendations in February 2015 in collaboration with the American Board of Internal Medicine Foundation and Consumer Reports.
The Professional Practice Committee (PPC) of the American Association of Neuromuscular & Electrodiagnostic Medicine (AANEM) developed this list of recommendations. The PPC members identified areas to be included on this list based on the greatest potential for overuse/misuse, quality improvement,and availability of strong evidence-based research/support in the literature.
Recommendation 1: Don't do a needle electromyography (EMG) test for isolated neck or back pain after a motor vehicle accident, as a needle EMG is unlikely to be helpful. Recommendation 2: Don't perform dermatomal somatosensory evoked potentials (SEPs) for a pinched nerve in the neck or back, as they are an unproven diagnostic procedure. Recommendation 3: Don't do a four limb needle EMG/nerve conduction study (NCS) testing for neck and back pain after trauma. Recommendation 4: Don't do nerve conduction studies without also doing a needle EMG for testing for radiculopathy, a pinched nerve in the neck or back.Recommendation 5: Don't do a magnetic resonance imaging(MRI) scan of the spine or brain for patients with only peripheral neuropathy (without signs or symptoms suggesting a brain or spine disorder).
探讨美国神经肌肉与电诊断医学协会(AANEM)在“明智选择”运动中的五大建议,该运动旨在对医生和患者进行高质量电诊断和神经肌肉医学方面的教育。AANEM于2015年2月与美国内科医学委员会基金会及《消费者报告》合作发布了其五大建议。
美国神经肌肉与电诊断医学协会(AANEM)的专业实践委员会(PPC)制定了这份建议清单。PPC成员根据过度使用/误用的最大可能性、质量改进以及文献中强有力的循证研究/支持的可得性,确定了清单上应包含的领域。
建议1:对于机动车事故后孤立的颈部或背部疼痛,不要进行针电极肌电图(EMG)检查,因为针电极EMG不太可能有帮助。建议2:对于颈部或背部受压神经,不要进行皮节体感诱发电位(SEP)检查,因为这是一种未经证实的诊断方法。建议3:对于创伤后颈部和背部疼痛,不要进行四肢针电极EMG/神经传导研究(NCS)检查。建议4:对于神经根病(颈部或背部受压神经)的检查,在未同时进行针电极EMG的情况下,不要进行神经传导研究。建议5:对于仅患有周围神经病变(无提示脑部或脊柱疾病的体征或症状)的患者,不要进行脊柱或脑部的磁共振成像(MRI)扫描。