Toward a Useful and Cost-Effective Workup in Chronic Polyneuropathy: The EXPRESS Study Protocol

Area of Science:

• Neurology
• Health Technology Assessment
• Clinical Diagnostics

Background:

• Existing knowledge gaps regarding the utility of blood tests and nerve conduction studies in polyneuropathy diagnosis.
• Hypothesis that a streamlined diagnostic approach reduces costs without sacrificing accuracy or impacting treatment.
• Need for evidence-based guidelines on essential investigations for chronic polyneuropathy.

Purpose of the Study:

• To identify necessary investigations for diagnosing chronic polyneuropathy in an outpatient setting.
• To conduct an early health technology assessment of diagnostic strategies.
• To compare the effectiveness and cost-efficiency of standard versus limited diagnostic workups.

Main Methods:

• Prospective, multicenter quality in healthcare evaluation.
• Comparison of standard diagnostic care versus a proposed limited workup strategy.
• Involvement of neurologists experienced in neuromuscular diseases in the study panel.

Main Results:

• Primary outcome: concordance between neurologist and panel diagnoses to assess limited workup effectiveness.
• Evaluation of cost differences and impact on treatment and patient management.
• Assessment of patient-reported outcomes including diagnostic burden, time, and quality of care.

Conclusions:

• The study will yield improved evidence on cost-effective diagnostic components for chronic polyneuropathy.
• Findings will inform optimized diagnostic pathways for suspected chronic polyneuropathy.
• This research contributes to enhancing the quality of healthcare in diagnosing polyneuropathy.