Investigation of concordance between referral diagnosis and electroneuromyographic diagnosis

Abstract

Aim: Electroneuromyography (ENMG) is an electrophysiological method of examination for neurophysiological state of motor neuron, peripheral nerve and muscle functions. This study was aimed to investigate the concordance of between referral diagnosis and ENMG diagnosis in patients referred to the electrophysiology laboratory. 

Methods: A retrospective cohort study is planned. Patients, whose evaluations of ENMG were requested by the orthopedic, neurology and physical therapy and rehabilitation physicians between June 2015 and December 2018, were included in this study. Descriptive statistics and Cohen’s Kappa Test were run for data set analysis.

Results: A total of 486 patients are included in the study. Of the 486 patients undergoing ENMG examination, 362 were female (74.5%) and 124 were male (25.5%). The mean age was 46.71±12.41. 35.2% (n=171) of the referral diagnoses were requested by orthopedics, 32.7% (n=159) by physical therapy and rehabilitation and 32.1% (n=156) by neurology clinics. When the consistency between the preliminary diagnosis and post-ENMG diagnosis was examined; 65.4% of the results were found to be compatible. According to the clinics; 76.3% of the requests referred by the neurology clinic and 64.8% of the requests referred by the physical therapy and rehabilitation clinic, 56.1% of the requests referred by the orthopedic clinic were confirmed by ENMG. As a result of the Cohen’s Kappa test, the total (κ) correlation between clinical preliminary diagnosis and ENMG diagnosis was found to be 0.574 (p<0.001). These findings demonstrated a moderate (0.41-0.60) concordance. When examined according to the clinics, compliance values; for the orthopedic clinic were 0.484 (p<0.001), 0.571 for the physical therapy and rehabilitation clinic (p<0.001) and 0.685 for the neurology clinic (p<0.001).

Conclusion: This study confirmed that ENMG should be considered as an extension of neurological examination.