Impact of medical audit on electrodiagnostic medicine in polyneuropathy

Kirsten Pugdahl, Anders Fuglsang-Frederiksen, Hatice Tankisi, Birger Johnsen, Mamede de Carvalho, Peter R W Fawcett, Annick Labarre-Vila, Rocco Liguori, Wilfred Nix, Ian S. Schofield

Research output: Contribution to journalArticle


Objective: The aim of the study was to investigate whether experienced physicians' electrodiagnostic practice and criteria can be influenced by international collaboration involving peer review medical audit. Methods: Data was obtained from the ESTEEM project, an ongoing collaboration since 1991 among European neurophysiologists concerned with quality improvement in electrodiagnostic medicine. Three sets of the physicians' polyneuropathy examinations performed with intervals of 2-4. years were analysed. Results: Changes towards increased homogeneity among the physicians were found in (1) the average number of studies performed per patient and the number of abnormal studies required for accepting the diagnosis of polyneuropathy, with the most pronounced changes seen for abnormal motor nerve segments, abnormal F-wave studies, and electromyographic studies, and (2) the agreement on pathophysiological interpretation of nerve conduction studies and classification of polyneuropathy. Conclusions: Changes towards increased homogeneity contributed to years of participation in peer review medical audit, were seen among a group of experienced physicians. Peer review medical audit as carried out here is however difficult to scale up. Therefore guidelines or minimal criteria should ideally supplement a medical audit process to disseminate the results obtained to a larger audience. Significance: These results support the role of international peer review medical audit in quality improvement of electrodiagnostic medicine.

Original languageEnglish
Pages (from-to)2523-2529
Number of pages7
JournalClinical Neurophysiology
Issue number12
Publication statusPublished - Dec 2011



  • Electromyography
  • Medical audit
  • Nerve conduction studies
  • Neurophysiology
  • Polyneuropathy

ASJC Scopus subject areas

  • Clinical Neurology
  • Neurology
  • Physiology (medical)
  • Sensory Systems

Cite this

Pugdahl, K., Fuglsang-Frederiksen, A., Tankisi, H., Johnsen, B., Carvalho, M. D., Fawcett, P. R. W., Labarre-Vila, A., Liguori, R., Nix, W., & Schofield, I. S. (2011). Impact of medical audit on electrodiagnostic medicine in polyneuropathy. Clinical Neurophysiology, 122(12), 2523-2529.