完善疑似腕管综合征电诊断测试的质量标准,以考虑可接受的实践差异:专家评审过程。

IF 2.8 3区 医学 Q2 CLINICAL NEUROLOGY
Muscle & Nerve Pub Date : 2024-09-01 Epub Date: 2024-06-12 DOI:10.1002/mus.28176
Kanaka D Shetty, Aashna R Basu, Teryl K Nuckols
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引用次数: 0

摘要

引言/目的:研究小组曾使用一套护理流程质量测量方法对疑似腕管综合征(CTS)患者进行电诊断检测,该方法记录了电诊断检测实践和质量测量方法遵守情况的巨大差异。本研究试图通过整合可接受的测试实践差异来提高质量测量的适用性和有效性:方法:我们招募了来自五个专业协会的 13 位电诊断医学专家。专家们反复完善了五项质量测量指标,然后对完善后的质量测量指标的有效性进行了评分(1-9 分)。在这一过程中,专家们回顾了现有质量标准的遵守情况和电诊断测试实践的变化情况,并考虑了美国神经肌肉和电诊断医学协会最近公布的质量标准:三项质量标准(CTS 手术前的电诊断测试、电诊断测试过程中的体温评估和严重正中神经病变的电诊断标准)几乎没有经过改进,且被评为有效(中位数为 8-9)。两项测量(电诊断的基本要素、将电诊断测试解释为中枢神经病变的标准)在修订后被评为有效(中位数为 8)。对于这些测量方法,专家们对感觉或混合神经传导研究推荐内容的评价各不相同:专家们对使用感觉峰值潜伏期的一致意见大于对起始潜伏期或感觉速度的一致意见:本研究制定的质量标准为疑似 CTS 的电诊断测试提供了最低标准,与之前的版本相比,这些标准更加全面和细致。未来的工作可以评估这些改进后的测量方法在不同医生实践中的可行性、可靠性和有效性。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Refining quality measures for electrodiagnostic testing in suspected carpal tunnel syndrome to account for acceptable variations in practice: Expert review process.

Introduction/aims: Using a set of process-of-care quality measures for electrodiagnostic testing in suspected carpal tunnel syndrome (CTS), the research team previously documented large variations in electrodiagnostic testing practices and adherence to quality measures. This study sought to enhance the applicability and validity of the quality measures by integrating acceptable variations in testing practices.

Methods: We recruited 13 expert electrodiagnostic medicine specialists from five specialty societies. The experts iteratively refined five quality measures, and then rated the validity of the refined quality measures (1-9 scale). During this process, the experts reviewed data on adherence to existing quality measures and variations in electrodiagnostic testing practices, and considered recently published quality measures from the American Association of Neuromuscular and Electrodiagnostic Medicine.

Results: Three quality measures (electrodiagnostic testing before surgery for CTS, temperature assessment during electrodiagnostic testing, and electrodiagnostic criteria for severe median neuropathy) underwent few refinements and were rated valid (medians 8-9). Two measures (essential components of electrodiagnosis, criteria for interpreting electrodiagnostic tests as median neuropathy) were judged valid (medians 8) after revisions. For these measures, experts' ratings on the recommended components of sensory or mixed nerve conduction studies varied: agreement among the experts about the use of sensory peak latency was greater than for onset latency or sensory velocity.

Discussion: This study produced quality measures that provide minimum standards for electrodiagnostic testing for suspected CTS that are more comprehensive and nuanced than prior versions. Future work can assess the feasibility, reliability, and validity of these refined measures in diverse physician practices.

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来源期刊
Muscle & Nerve
Muscle & Nerve 医学-临床神经学
CiteScore
6.40
自引率
5.90%
发文量
287
审稿时长
3-6 weeks
期刊介绍: Muscle & Nerve is an international and interdisciplinary publication of original contributions, in both health and disease, concerning studies of the muscle, the neuromuscular junction, the peripheral motor, sensory and autonomic neurons, and the central nervous system where the behavior of the peripheral nervous system is clarified. Appearing monthly, Muscle & Nerve publishes clinical studies and clinically relevant research reports in the fields of anatomy, biochemistry, cell biology, electrophysiology and electrodiagnosis, epidemiology, genetics, immunology, pathology, pharmacology, physiology, toxicology, and virology. The Journal welcomes articles and reports on basic clinical electrophysiology and electrodiagnosis. We expedite some papers dealing with timely topics to keep up with the fast-moving pace of science, based on the referees'' recommendation.
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