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Zwirlein, Melanie

Mayo Clinic

University of Maryland, Baltimore

Citations 1

Proficiency of nerve conduction using standard methods and reference values (cl. NPhys Trial 4)
Litchy, William J. , Albers, James W., Wolfe, James, Bolton, Charles F., WALSH, NANCY, Klein, Christopher J. , Zafft, Andrew J., Russell, James W. , Zwirlein, Melanie, Overland, Carol J., Davies, Jenny L., Carter, Rickey E. , Dyck, P. James B. , Investigators, the CI. Nphys Trial 4, Tesfaye, Solomon , Investigators, the CI. Nphys Trial 4, Klein, Christopher J , Carter, Rickey E

Muscle & Nerve | March 19, 2014 | Volume: 50 | Issue: 6 | Pages: 900-908

10.1002/mus.24243 Get It

ABSTRACTIntroductionThe 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. Muscle Nerve 50: 900–908, 2014