The evaluation of distal symmetric polyneuropathy: utilisation and expenditures
by community neurologists.
Authors Callaghan BC, Kerber KA, Banerjee M, Feldman EL, Morgenstern LB, Longoria R,
Rodgers A, Longwell P, Lisabeth LD
Submitted By Eva Feldman on 4/15/2016
Status Published
Journal Journal of neurology, neurosurgery, and psychiatry
Year 2016
Date Published
Volume : Pages 87 : 113 - 4
PubMed Reference 25604430
Abstract Previous studies show that electrodiagnostic tests and MRIs are frequently
ordered in the initial evaluation of neuropathy.1 ,2 However, American Academy
of Neurology (AAN) guideline-supported tests, particularly the glucose tolerant
test (GTT), are often omitted.1 Recent evidence suggests that electrodiagnostic
studies and MRIs are the primary drivers of expenditures associated with
neuropathy testing despite limited data to support their use.3 However, these
results are based on Medicare claims; therefore, it remains unclear if this
observation applies to other populations and when using a more rigorous case
definition of neuropathy. Furthermore, Medicare claims do not provide detailed
clinical information that would allow for investigation of patient-level factors
associated with utilisation and expenditures.

Our aim was to determine utilisation and expenditures in the evaluation of a new
diagnosis of distal symmetric polyneuropathy (DSP) by community neurologists
using a population-based design and a strict case definition. We also sought to
determine which patient and physician factors were associated with testing
expenditures, electrodiagnostic and MRI utilisation.

Investigators with authorship
Eva FeldmanUniversity of Michigan