EVALUATION OF THE ELECTROMYOGRAPHY REQUESTS IN A TERTIARY CENTER

ABSTRACT
Objective: Electrodiagnostic studies encompass nerve conduction studies and needle electromyography. The rationale behind the requests and diagnostic concordance according to referring clinic, coupled with escalating healthcare expenditures, have garnered considerable scholarly attention and been the focus of studies. Our study aims to compare the consistency of referred cases according to clinic and the interpretation of nerve conduction studies and needle electromyography studies, comparing the findings with previous studies evaluating electromyography requests.
Patients and Methods: In this study, data were included from 1136 patients, consisting of 590 women and 549 men who underwent electrodiagnostic examinations in our laboratory over a period of two years. These data were retrospectively analyzed, and the findings were evaluated in terms of demographic characteristics, reasons for referral, results, referring clinics, and diagnostic concordance.
Results: Electromyographic investigations were found to have a general pathology detection rate of approximately 60%. The preliminary diagnoses most requested were polyneuropathy and entrapment neuropathy, respectively. Most entrapment neuropathy referrals were from Orthopedics (60%), while the majority of polyneuropathy requests came from Neurology and Internal Medicine. Tests were reported as pathological in more than half of the cases. The overall concordance rate was found to be 44.8%. When examining the concordance between the referral diagnosis and the final diagnosis for entrapment neuropathies, the Physical Medicine and Rehabilitation clinic exhibited the highest rate at 42%. The rate of discrepancy between referral and outcome was significantly high in referrals with multiple indications.
Conclusion: The usefulness of electromyography for diagnosis and treatment is closely associated with pre-diagnostic considerations and the department responsible for the request. The concordance between referrals and outcomes can be predicted.
Keywords: Neurological diagnostic technique, nerve conduction study, electromyography, tertiary referral center