Can medical audit change electromyographic practice?

Considerable variation in EMG practice has been described previously. Since 1992, 7 clinical neurophysiologists from 6 European countries prospectivel y collected electromyographic (EMG) examinations. The aim of this study was to examine whether several years of mutual influence among physicians usin g medical audit resulted in a more uniform EMG practice. We studied whether there was a change in the number of examinations per patient and the techn iques used from the first 12 to the last 12 EMG examinations on patients wi th polyneuropathy. For F-wave studies and motor nerve studies, there was a clear change towards a more uniform practice. For sensory nerve conduction studies and muscle studies, there were only minor changes. With regard to e xamination techniques, there was a reduction in the use of more time-consum ing examination techniques (near-nerve sensory studies and quantitative mus cle studies). It seems possible to change the EMG practice of individual ph ysicians by international collaboration and medical audit. However, until n ow most changes have been minor and large differences in European EMG pract ices persist. The diversity of practices suggests a need for studies on the optimal application of existing examination techniques. (C) 1998 Elsevier Science Ireland Ltd. All rights reserved.