Beyond the Waves: Assessment of the Clinical Appropriateness of Electroencephalography Referrals in Neurological...

This cross-sectional study evaluated the appropriateness of electroencephalography (EEG) referrals at the Department of Neurology, King Edward Medical University, Mayo Hospital, Lahore, Pakistan, from January to December 2023. Among 1,000 participants with a mean age of 31.4 ± 17 years, most patients were adults (714, 71.4%), and outpatient visits predominated (689, 68.9%). Neurology was the primary referring department (445, 44.5%). EEG findings were predominantly normal (918, 91.8%), with abnormal findings in 82 (8.2%) of cases, comprising epileptiform abnormalities (57, 5.7%) and non-epileptiform abnormalities (25, 2.5%). Appropriate referrals accounted for (275, 27.5%), with inappropriate referrals mainly to rule out organic causes of psychiatric disorders (175, 17.5%). Significant variations were observed in appropriateness among departments and provisional diagnoses (p <0.05). Over half of EEG requests were inappropriate, reflecting misconceptions about its diagnostic utility. Enhanced physician education and adherence to guidelines are critical to optimise resource utilisation and improve diagnostic accuracy in neurological practice. Key Words: Electroencephalography, Referral practice, Appropriateness, Inappropriate EEG requests, Healthcare resource optimisation.