腕管综合征电诊断检测的质量：对质量措施的依从性。

Quality of electrodiagnostic testing for carpal tunnel syndrome: adherence to quality measures.

机构信息

VA Greater Los Angeles Healthcare System, Los Angeles, California, USA.

Employee Health, The Permanente Medical Group, Oakland, California, USA.

出版信息

Muscle Nerve. 2020 Jul;62(1):50-59. doi: 10.1002/mus.26858. Epub 2020 Apr 27.

DOI:10.1002/mus.26858

PMID:32133653

Abstract

INTRODUCTION

Research has shown that quality of health-care services is often suboptimal. Little is known about the quality of electrodiagnostic testing.

METHODS

We prospectively recruited 477 adults with workers' compensation claims for carpal tunnel syndrome (CTS) from 30 occupational health clinics and evaluated whether electrodiagnostic testing adhered to five process-oriented quality measures.

RESULTS

Among patients who had surgery for CTS, nearly all underwent recommended preoperative electrodiagnostic testing (measure #1, 170 of 174, 97.7%). Most electrodiagnostic tests included essential components (measure #2, 295 of 379, 77.8%). However, few reports documented skin temperature (measure #3, 93 of 379, 24.5%) and criteria were seldom met for interpreting test findings as consistent with CTS (measure #4, 41 of 284, 14.4%) or "severe" CTS (measure #5, 8 of 46, 17.4%).

DISCUSSION

Most patients underwent testing before surgery, but test quality was often suboptimal. This work lays the groundwork for future efforts to monitor and improve the quality of electrodiagnostic testing for CTS.

摘要

简介

研究表明，医疗服务质量往往不尽如人意。关于电诊断检测的质量知之甚少。

方法

我们前瞻性地招募了 30 家职业健康诊所的 477 名因腕管综合征（CTS）而申请工人赔偿的成年人，并评估了电诊断测试是否符合五个面向过程的质量措施。

结果

在接受 CTS 手术的患者中，几乎所有患者都接受了推荐的术前电诊断测试（措施 #1，174 例中有 170 例，97.7%）。大多数电诊断测试都包含了必要的组件（措施 #2，379 例中有 295 例，77.8%）。然而，很少有报告记录皮肤温度（措施 #3，379 例中有 93 例，24.5%），并且很少有标准将测试结果解释为符合 CTS（措施 #4，284 例中有 41 例，14.4%）或“严重” CTS（措施 #5，46 例中有 8 例，17.4%）。