Impact of electrodiagnostic (EMG/NCS) tests on clinical decision-making and patient perceived benefit in the outpatient physical therapy practice

Abstract

Background: Utilizing Electromyography and Nerve Conduction Study (EMG/NCS) tests, when indicated, may have implications for efficient patient management and assist in more efficient referral to appropriate providers or specialists.

Objective: To investigate the impact of Electromyography and Nerve Conduction Studies (EMG/NCS) on clinical decision-making and patient perspectives within PT practice settings.

Methods: 462 patients, who were candidates for diagnostic testing (EMG/NCS) were included in this outcome study and questionnaire-based survey design. Pre-test diagnosis was compared to post-test diagnosis. Post-test, patients were asked to rate their perceived benefit of the testing.

Results: Management was changed in 60.61% of patients post EMG/NCS testing (p < 0.0001). The diagnosis was changed post-EMG/NCS test in 39% of the patients with a change in management, which is greater than expected (p < 0.0004). There was no effect of gender or age (p > 0.05) on change in treatment (tx) or diagnosis (dx). 89.8% of patients agreed, or strongly agreed, that they were better able to understand their condition; 92.4% strongly agreed, or agreed, that they were reassured about their condition; 89.1% strongly agreed, or agreed, that they were better able to manage their condition and 92% reported very high, or high, value perceived from the EMG/NCS test administered.

Conclusion: This study demonstrates that EMG/NCS testing appears to have a significant impact on clinical decision-making, and higher scores on the patient perceived benefit.