Does specificity of electrodiagnostic test referrals predict test outcome in children?

Area of Science:

• Pediatric Neurology
• Neuromuscular Disorders
• Diagnostic Testing

Background:

• Electrodiagnostic testing (EDX) is crucial for diagnosing pediatric neuromuscular diseases.
• Non-specific referrals are increasingly common reasons for EDX in children.
• The impact of referral specificity on EDX outcomes in pediatric patients requires investigation.

Purpose of the Study:

• To determine if referral specificity predicts electrodiagnostic testing outcomes in children.
• To analyze the relationship between pre-test diagnostic information and EDX results.
• To identify factors influencing the accuracy of EDX referrals in pediatric populations.

Main Methods:

• A 7-year audit (2013-2020) of EDX referrals and outcomes at CHI-Crumlin.
• Coding of pre-test details and comparison with EDX outcomes.
• Utilized multinomial logistic regression to analyze the data.

Main Results:

• Electrodiagnostic testing (EDX) was performed on 702 children; 36% lacked a specified pre-test diagnosis.
• Referral specificity and absence of pain predicted abnormal EDX outcomes.
• Accuracy of pre-test diagnoses was highest for suspected anterior horn cell disorders (67%).
• Referral accuracy and abnormal outcomes were negatively impacted by pain as a primary symptom.

Conclusions:

• Electrodiagnostic testing (EDX) provides valuable information in pediatric cases.
• A lack of specified working diagnosis or referral for pain decreases the probability of abnormal EDX findings.
• Improving referral specificity can enhance the diagnostic yield of EDX in children.