INESSS has published a report on the use of electrodiagnostic exams in neurological investigation.
Electrodiagnostic examination, defined as a combination of electromyography and/or nerve conduction study, is potentially useful in identifying the pathological process, the etiology, location and severity of an impairment for several neurological, muscular or neuromuscular conditions.
This examination is not a diagnostic test prescribed in isolation but is an extension of the physical and neurological examination, in the context of a consultation specialized in neurology or physiatry. The appropriate use of the electrodiagnostic examination will therefore rely mainly on clinical identification, from the first-line consultation, patients with probable peripheral nervous system involvement and whose electrodiagnostic examination is likely to clarify the diagnosis and improve management.
Further to concerns raised by the Association des neurologilogues du Québec regarding potential over-prescription of electromyography in requests for specialized consultations, INESSS first produced a portrait of the current use of electrodiagnostic examination in Quebec based on clinical-administrative data. Then, 17 clinical indications and a decision support tool were developed based on clinical practice guidelines, scientific journals and expert panel consultation.
The indications and the proposed tool have the potential to increase the relevance of specialized consultation requests and reduce the number of low diagnostic value procedures.