Neuropathy patients more likely to receive high-cost, screening instead of more effective tests

Researchers at the University of Michigan analyzed the tremendous cost of diagnosing peripheral neuropathy and found that less expensive, more effective tests are less likely to be used.

Almost one-quarter of patients receiving neuropathy diagnoses undergo high-cost, low-yield MRIs while very few receive low-cost, high-yield glucose tolerance tests, according to the study that will be published Jan. 23 in the .

The research was led by Brian Callaghan, M.D., assistant professor of at the University of Michigan Medical School.

Patients diagnosed with typically are given many tests but physicians are highly variable in their approach, says Callaghan.

"We spend a lot of money to work up a diagnosis of neuropathy. The question is whether that money is well spent," Callaghan says.

For patients with peripheral neuropathy, the nerves that carry information to and from the don't work property. This commonly leads to tingling or burning in arms or and loss of feeling — and the symptoms can go from subtle to severe.

Diabetes is the most common cause of this type of problem. Peripheral neuropathy is found in about 15 percent of those over age 40.

Researchers used the 1996-2007 Health and Retirement Study to identify individuals with a diagnosis of peripheral neuropathy. They focused on 15 relevant tests and examined the number and patterns of tests six months before and after the initial diagnosis.

"Our findings, that MRIs were frequently ordered by , but a lower-cost glucose tolerance test was rarely ordered, show that there is substantial opportunity to improve efficiency in the evaluation of peripheral neuropathy," Callaghan says.

"Currently no standard approach to the evaluation of peripheral neuropathy exists . We need more research to determine an optimal approach.

"We do a lot of tests that cost a lot of money, and there's no agreement on what we're doing."

The climbing rates of diabetes in the U.S. make this research even more important, says co-author Kenneth M. Langa, M.D., Ph.D., a professor of Internal Medicine at U-M, a Research Scientist at the VA Ann Arbor Healthcare System's Center for Clinical Management Research, and Research Professor at the Institute for Social Research.

"We know more and more people may develop peripheral neuropathy because it is commonly caused by diabetes. Our study suggests that the work-up currently used for neuropathy isn't standardized and tests that are less useful and more expensive may be used too often," says Langa. "We need a more efficient way to handle this increasingly common ."

More information: Arch Intern Med. 2012; 172[2]:127-132.

add to favorites email to friend print save as pdf

Related Stories

Researchers uncover source of mystery pain

Jun 22, 2011

An estimated 20 million people in the United States suffer from peripheral neuropathy, marked by the degeneration of nerves and in some cases severe pain. There is no good treatment for the disorder and doctors can find no ...

Recommended for you

UN says Syria vaccine deaths was an NGO 'mistake'

1 hour ago

The recent deaths of Syrian children after receiving measles vaccinations was the result of a "mistake" by a non-governmental partner who mixed in a muscle relaxant meant for anesthesia, a spokesman for the U.N. secretary-general ...

First US child dies from enterovirus D68

1 hour ago

A child in the northeastern US state of Rhode Island has become the first to die from an ongoing outbreak of a respiratory virus, enterovirus D68, health officials said Wednesday.

US Ebola patient had contact with kids: governor

1 hour ago

A man who was diagnosed with Ebola in virus in Texas came in contact with young children, and experts are monitoring them for any signs of disease, governor Rick Perry said Wednesday.

UN worker dies of suspected Ebola in Liberia

2 hours ago

The United Nations mission in Liberia announced on Wednesday the first suspected victim among its employees of the deadly Ebola epidemic ravaging the impoverished west African nation.

AAO-HNSF clinical practice guideline: Tinnitus

2 hours ago

The American Academy of Otolaryngology—Head and Neck Surgery Foundation has released the first ever mutli-disciplinary, evidence-based clinical practice guideline to improve the diagnosis and management of tinnitus, the ...

User comments