Proficiency of nerve conduction using standard methods and reference values (cl. NPhys Trial 4)

ABSTRACT Introduction The Cl. NPhys Trial 3 showed that attributes of nerve conduction (NC) were without significant intraobserver differences, although there were significant interobserver differences. Methods: Trial 4 tested whether use of written instructions and pretrial agreement on techniques...

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Published inMuscle & nerve Vol. 50; no. 6; pp. 900 - 908
Main Authors Litchy, William J., Albers, James W., Wolfe, James, Bolton, Charles F., Walsh, Nancy, Klein, Christopher J., Zafft, Andrew J., Russell, James W., Zwirlein, Melanie, Overland, Carol J., Davies, Jenny L., Carter, Rickey E., Dyck, Peter J.
Format Journal Article
LanguageEnglish
Published United States Blackwell Publishing Ltd 01.12.2014
Wiley Subscription Services, Inc
Subjects
Aged
Agreements
Diabetic Neuropathies - diagnosis
Diabetic Neuropathies - physiopathology
Electrodiagnosis - methods
Humans
Leg - innervation
Methods
multicenter trial
nerve conduction accuracy
nerve conduction proficiency
Neural Conduction - physiology
neuropathy impairment score
Neurophysiology - methods
Neurophysiology - standards
Observer Variation
Reference Values
Reproducibility of Results
reference values
nerve conduction proficiency
neuropathy impairment score
multicenter trial
nerve conduction accuracy
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Summary:ABSTRACT Introduction The Cl. NPhys Trial 3 showed that attributes of nerve conduction (NC) were without significant intraobserver differences, although there were significant interobserver differences. Methods: Trial 4 tested whether use of written instructions and pretrial agreement on techniques and use of standard reference values, diagnostic percentile values, or broader categorization of abnormality could reduce significant interobserver disagreement and improve agreement among clinical neurophysiologists. Results: The Trial 4 modifications markedly decreased, but did not eliminate, significant interobserver differences of measured attributes of NC. Use of standard reference values and defined percentile values of abnormality decreased interobserver disagreement and improved agreement of judgment of abnormality among evaluators. Therefore, the same clinical neurophysiologist should perform repeat NCs of therapeutic trial patients. Conclusions: Differences in interobserver judgment of abnormality decrease with use of common standard reference values and a defined percentile level of abnormality, providing a rationale for their use in therapeutic trials and medical practice. Muscle Nerve 50: 900–908, 2014
Bibliography:ArticleID:MUS24243
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istex:13B4DD10CDEBE4C83AEABE87D35C70CC45626C8E
P.J.D. serves as an Associate Editor for
The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. The authors have full access to all the data and the right to publish any and all data, separate and apart from the guidance of any sponsor.
This study was supported in part by Mayo Foundation Funds and grants obtained from the National Institute of Neurological Disorders and Stroke (R01‐NS36797 to P.J.D.) and the National Institute on Aging (R01‐AG34676 to W.A.R.).
and receives an honorarium. His laboratory receives financial support from the Mayo Foundation; Pfizer, Inc.; Isis, Inc.; and Alnylam, Inc.; and previously from the National Institutes of Health (NS 36797), FDA, and other pharmaceutical companies.
Diabetes
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ISSN:0148-639X
1097-4598
DOI:10.1002/mus.24243