Background: Extensive investigations are often performed to reveal the cause of chronic polyneuropathy. It is not known whether a restrictive diagnostic guideline improves cost efficiency without loss of diagnostic re...Background: Extensive investigations are often performed to reveal the cause of chronic polyneuropathy. It is not known whether a restrictive diagnostic guideline improves cost efficiency without loss of diagnostic reliability. Methods: In a prospective multicentre study, a comparison was made between the workup in patients with chronic polyneuropathy before and after guideline implementation. Results: Three hundred and ten patients were included: 173 before and 137 after g uideline implementation. In all patients, the diagnosis would remain the same if the workup was limited to the investigations in the guideline. After guideline implementation, the time to reach a diagnosis decreased by two weeks. There was a reduction of 33%in the number and costs of routine laboratory inves tigations/patient, and a reduction of 27%in the total number of laboratory tests/patient, despite low guideline adherence. Conclusion: The implementation of a diagnostic guideline for chronic polyneuropathy can reduce diagnostic delay an d the number and costs of investigations for each patient without loss of diag nostic reliability. Continuous evaluation strategies after guideline implementat ion may improve guideline adherence and cost efficiency.展开更多
文摘Background: Extensive investigations are often performed to reveal the cause of chronic polyneuropathy. It is not known whether a restrictive diagnostic guideline improves cost efficiency without loss of diagnostic reliability. Methods: In a prospective multicentre study, a comparison was made between the workup in patients with chronic polyneuropathy before and after guideline implementation. Results: Three hundred and ten patients were included: 173 before and 137 after g uideline implementation. In all patients, the diagnosis would remain the same if the workup was limited to the investigations in the guideline. After guideline implementation, the time to reach a diagnosis decreased by two weeks. There was a reduction of 33%in the number and costs of routine laboratory inves tigations/patient, and a reduction of 27%in the total number of laboratory tests/patient, despite low guideline adherence. Conclusion: The implementation of a diagnostic guideline for chronic polyneuropathy can reduce diagnostic delay an d the number and costs of investigations for each patient without loss of diag nostic reliability. Continuous evaluation strategies after guideline implementat ion may improve guideline adherence and cost efficiency.
