Neuropathy patients more likely to receive high-cost, screening instead of more effective tests

 

U-M researchers found more efficient diagnostic tools are not always used, results reported in Archives of Internal Medicine

 

Ann Arbor, MI, USA (January 23, 2012) – Researchers at the University of Michigan analyzed the tremendous cost of diagnosing peripheral neuropathy and found that less expensive, more effective tests are less likely to be used. Almost one-quarter of patients receiving neuropathy diagnoses undergo high-cost, low-yield MRIs while very few receive low-cost, high-yield glucose tolerance tests, according to the study that will be published Jan. 23 in the Archives of Internal Medicine.

 

The research was led by Brian Callaghan, M.D., assistant professor of neurology at the University of Michigan Medical School.

 

Patients diagnosed with peripheral neuropathy typically are given many tests but physicians are highly variable in their approach, says Callaghan. "We spend a lot of money to work up a diagnosis of neuropathy. The question is whether that money is well spent," Callaghan says.For patients with peripheral neuropathy, the nerves that carry information to and from the brain don’t work property. This commonly leads to tingling or burning in arms or legs and loss of feeling — and the symptoms can go from subtle to severe.

 

Diabetes is the most common cause of this type of nerve problem. Peripheral neuropathy is found in about 15 percent of those over age 40.

 

Researchers used the 1996-2007 Health and Retirement Study to identify individuals with a diagnosis of peripheral neuropathy. They focused on 15 relevant tests and examined the number and patterns of tests six months before and after the initial diagnosis.

 

"Our findings, that MRIs were frequently ordered by physicians, but a lower-cost glucose tolerance test was rarely ordered, show that there is substantial opportunity to improve efficiency in the evaluation of peripheral neuropathy," Callaghan says. "Currently no standard approach to the evaluation of peripheral neuropathy exists . We need more research to determine an optimal approach. "We do a lot of tests that cost a lot of money, and there’s no agreement on what we’re doing."

 

The climbing rates of diabetes in the U.S. make this research even more important, says co-author Kenneth M. Langa, M.D., Ph.D., a professor of Internal Medicine at U-M, a Research Scientist at the VA Ann Arbor Healthcare System’s Center for Clinical Management Research, and Research Professor at the Institute for Social Research.

 

"We know more and more people may develop peripheral neuropathy because it is commonly caused by diabetes. Our study suggests that the work-up currently used for neuropathy isn’t standardized and tests that are less useful and more expensive may be used too often," says Langa. "We need a more efficient way to handle this increasingly common diagnosis."

 

 

  • Journal reference: Arch Intern Med. 2012; 172[2]:127-132.

 

  • Funding: National Institutes of Health, Katherine Rayner Program and A. Alfred Taubman Medical Research Institute. The Health and Retirement Study is supported by the National Institute on Aging.

 

  • Additional authors: Ryan McCammon, Kevin Kerber, M.D., Xiao Xu, Ph.D., and Eva Feldman, M.D., Ph.D.; all of the University of Michigan.

 

About the University of Michigan’s Department of Neurology: The department is an academic medical department with a full range of activities in patient care, education and research. The Neurology inpatient service provides care for acutely ill patients with neurologic disease and includes a dedicated intensive care unit, a separate stroke unit, and inpatient epilepsy monitoring beds. Our faculty also investigate the causes, treatments, natural history and phenotypic spectrum of inherited neurologic disorders, such as Alzheimer’s disease. Our studies range from describing novel inherited neurologic syndromes; to family studies including genetic mapping; discovering genes for neurologic diseases; and the creation and analysis of laboratory animals of neurologic disease.

 

 


University of Michigan Health System, 23.01.2012

MEDICAL NEWS

Fitness watches generate useful information, but increase patient anxiety
A new device provides added protection against COVID-19 during endoscopic…
81 million Americans lacking space or bathrooms to follow COVID…
Front-line physicians stressed and anxious at work and home
EULAR: High-Dose Glucocorticoids and IL-6 Receptor inhibition can reduce COVID-19…

SCHMERZ PAINCARE

Morbus Fabry mittels Datenanalysen aus dem PraxisRegister Schmerz aufspüren
Neandertaler besaßen niedrigere Schmerzschwelle
Deutscher Schmerz- und Palliativtag 2020 – ONLINE
Deutsche Gesellschaft für Schmerzmedizin fordert Anerkennung von Nicht-Psychologen in der…
DBfK: Besondere Rolle für Pflegeexpert/innen Schmerz – nicht nur in…

DIABETES

“Körperstolz”: Michael Krauser managt seinen Diabetes digital
Der richtige Sensor – von Anfang an
Diabetes mellitus: Ein Risikofaktor für frühe Darmkrebserkrankungen
Fastenmonat Ramadan: Alte und neue Herausforderung für chronisch Erkrankte während…
Sanofi setzt sich für die Bedürfnisse von Menschen mit Diabetes…

ERNÄHRUNG

Corona-Erkrankung: Fehl- und Mangelernährung sind unterschätze Risikofaktoren
Gesundheitliche Auswirkungen des Salzkonsums bleiben unklar: Weder der Nutzen noch…
Fast Food, Bio-Lebensmittel, Energydrinks: neue Daten zum Ernährungsverhalten in Deutschland
Neue Daten zur Ernährungssituation in deutschen Krankenhäusern und Pflegeheimen: Mangelernährung…
Baxter: Parenterale Ernährung von Patienten mit hohem Aminosäurenbedarf

ONKOLOGIE

Darolutamid bei Prostatakarzinom: Hinweis auf beträchtlichen Zusatznutzen
Multiples Myelom: Wissenschaftler überprüfen den Stellenwert der Blutstammzelltransplantation
Neues zur onkologischen Supportiv- und Misteltherapie und aktuelle Kongress-Highlights zum…
Finanzierung der ambulanten Krebsberatung weiterhin nicht gesichert
Lungenkrebsscreening mittels Low-Dose-CT

MULTIPLE SKLEROSE

Geschützt: Multiple Sklerose: Novartis’ Siponimod verzögert Krankheitsprogression und Hirnatrophie bei…
Neurofilamente als Diagnose- und Prognosemarker für Multiple Sklerose
Bedeutung der Langzeittherapie bei Multipler Sklerose – mehr Sicherheit und…
Bristol Myers Squibb erhält Zulassung der Europäischen Kommission für Ozanimod…
Einige MS-Medikamente könnten vor SARS-CoV-2/COVID-19 schützen

PARKINSON

Neue Studie zur tiefen Hirnstimulation bei Parkinson-Erkrankung als Meilenstein der…
Putzfimmel im Gehirn
Parkinson-Patienten in der Coronakrise: Versorgungssituation und ein neuer Ratgeber
Neuer Test: Frühzeitige Differenzialdiagose der Parkinson-Erkrankung
Gegen das Zittern: Parkinson- und essentiellen Tremor mit Ultraschall behandeln…