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Comparative Study
. 2014 Dec;50(6):900-8.
doi: 10.1002/mus.24243. Epub 2014 Oct 30.

Proficiency of nerve conduction using standard methods and reference values (Cl. NPhys Trial 4)

William J Litchy  1 , James W Albers, James Wolfe, Charles F Bolton, Nancy Walsh, Christopher J Klein, Andrew J Zafft, James W Russell, Melanie Zwirlein, Carol J Overland, Jenny L Davies, Rickey E Carter, Peter J Dyck; CI. Nphys Trial 4 Investigators
Collaborators, Affiliations
Comparative Study

Proficiency of nerve conduction using standard methods and reference values (Cl. NPhys Trial 4)

William J Litchy et al. Muscle Nerve. 2014 Dec.

Abstract

Introduction: The Cl. NPhys Trial 3 showed that attributes of nerve conduction (NC) were without significant intraobserver differences, although there were significant interobserver differences.

Methods: Trial 4 tested whether use of written instructions and pretrial agreement on techniques and use of standard reference values, diagnostic percentile values, or broader categorization of abnormality could reduce significant interobserver disagreement and improve agreement among clinical neurophysiologists.

Results: The Trial 4 modifications markedly decreased, but did not eliminate, significant interobserver differences of measured attributes of NC. Use of standard reference values and defined percentile values of abnormality decreased interobserver disagreement and improved agreement of judgment of abnormality among evaluators. Therefore, the same clinical neurophysiologist should perform repeat NCs of therapeutic trial patients.

Conclusions: Differences in interobserver judgment of abnormality decrease with use of common standard reference values and a defined percentile level of abnormality, providing a rationale for their use in therapeutic trials and medical practice.

Keywords: multicenter trial; nerve conduction accuracy; nerve conduction proficiency; neuropathy impairment score; reference values.

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