Testing Patterns to Diagnose Neuropathy Vary Widely

Median of four tests performed per patient, with high-cost tests used more frequently

FRIDAY, Jan. 27 (HealthDay News) -- Patients diagnosed with peripheral neuropathy undergo a median of four tests, with variability seen in testing patterns, according to a study published in the Jan. 23 issue of the Archives of Internal Medicine.

Brian Callaghan, M.D., of the University of Michigan in Ann Arbor, and colleagues examined the 1996 to 2007 Health and Retirement Study Medicare claims-linked database to identify individuals with an incident diagnosis of peripheral neuropathy. Patients with no previous neuropathy diagnosis during the preceding 30 months were included, and the researchers focused on 15 relevant tests to investigate the number and patterns of tests and specific test utilization six months before and after the incident neuropathy diagnosis. Medicare expenditures were evaluated in the baseline, diagnostic, and follow-up phases.

The researchers found that 1,031 of the 12,673 patients (8.1 percent) received a diagnosis of neuropathy and met inclusion criteria. A median of four tests were performed, and more than 400 testing patterns were seen. Magnetic resonance imaging of the brain or spine was ordered in 23.2 percent of patients, whereas only 1 percent received a glucose tolerance test. Compared with the baseline period, the mean Medicare expenditures were significantly higher in the diagnostic period ($14,362 versus $8,067).

"Patients diagnosed as having peripheral neuropathy typically undergo many tests, but testing patterns are highly variable," the authors write.

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