OBJECTIVE: To discuss the American Association of Neuromuscular & Electrodiagnostic Medicine (AANEM)'s Top Five Recommendations in the Choosing Wisely campaign educating physicians and patients on high quality electrodiagnostic and neuromuscular medicine. The AANEM published its Top Five Recommendations in February 2015 in collaboration with the American Board of Internal Medicine Foundation and Consumer Reports. METHODS: The Professional Practice Committee (PPC) of the American Association of Neuromuscular & Electrodiagnostic Medicine (AANEM) developed this list of recommendations. The PPC members identified areas to be included on this list based on the greatest potential for overuse/misuse, quality improvement,and availability of strong evidence-based research/support in the literature. RESULTS AND RECOMMENDATIONS: Recommendation 1: Don't do a needle electromyography (EMG) test for isolated neck or back pain after a motor vehicle accident, as a needle EMG is unlikely to be helpful. Recommendation 2: Don't perform dermatomal somatosensory evoked potentials (SEPs) for a pinched nerve in the neck or back, as they are an unproven diagnostic procedure. Recommendation 3: Don't do a four limb needle EMG/nerve conduction study (NCS) testing for neck and back pain after trauma. Recommendation 4: Don't do nerve conduction studies without also doing a needle EMG for testing for radiculopathy, a pinched nerve in the neck or back.Recommendation 5: Don't do a magnetic resonance imaging(MRI) scan of the spine or brain for patients with only peripheral neuropathy (without signs or symptoms suggesting a brain or spine disorder).
OBJECTIVE: To discuss the American Association of Neuromuscular & Electrodiagnostic Medicine (AANEM)'s Top Five Recommendations in the Choosing Wisely campaign educating physicians and patients on high quality electrodiagnostic and neuromuscular medicine. The AANEM published its Top Five Recommendations in February 2015 in collaboration with the American Board of Internal Medicine Foundation and Consumer Reports. METHODS: The Professional Practice Committee (PPC) of the American Association of Neuromuscular & Electrodiagnostic Medicine (AANEM) developed this list of recommendations. The PPC members identified areas to be included on this list based on the greatest potential for overuse/misuse, quality improvement,and availability of strong evidence-based research/support in the literature. RESULTS AND RECOMMENDATIONS: Recommendation 1: Don't do a needle electromyography (EMG) test for isolated neck or back pain after a motor vehicle accident, as a needle EMG is unlikely to be helpful. Recommendation 2: Don't perform dermatomal somatosensory evoked potentials (SEPs) for a pinched nerve in the neck or back, as they are an unproven diagnostic procedure. Recommendation 3: Don't do a four limb needle EMG/nerve conduction study (NCS) testing for neck and back pain after trauma. Recommendation 4: Don't do nerve conduction studies without also doing a needle EMG for testing for radiculopathy, a pinched nerve in the neck or back.Recommendation 5: Don't do a magnetic resonance imaging(MRI) scan of the spine or brain for patients with only peripheral neuropathy (without signs or symptoms suggesting a brain or spine disorder).
Authors: James F Burke; Eve A Kerr; Ryan J McCammon; Rob Holleman; Kenneth M Langa; Brian C Callaghan Journal: Neurology Date: 2016-07-08 Impact factor: 9.910