A trial of proficiency of nerve conduction: Greater standardization still needed

Peter J. Dyck, James W. Albers, James Wolfe, Charles F. Bolton, Nancy Walsh, Christopher J. Klein, Andrew J. Zafft, James W. Russell, Karen Thomas, Jenny L. Davies, Rickey E. Carter, L. Joseph Melton, William J. Litchy

Research output: Contribution to journalArticlepeer-review

33 Scopus citations


Introduction: The aim of this study was to test the proficiency (accuracy among evaluators) of measured attributes of nerve conduction (NC). Methods: Expert clinical neurophysiologists, without instruction or consensus development, from 4 different medical centers, independently assessed 8 attributes of NC in 24 patients with diabetes mellitus (DM) on consecutive days. Results: No significant intraobserver differences between days 1 and 2 were found, but significant interobserver differences were seen. Use of standard reference values did not correct for these observed differences. Conclusions: Interobserver variability was attributed to differences in performance of NC. It was of sufficient magnitude that it is of concern for the conduct of therapeutic trials. To deal with interrater variability in therapeutic trials, the same electromyographers should perform all NC assessments of individual patients or, preferably, NC procedures should be more standardized. A further trial is needed to test whether such standardization would eliminate interobserver variability.

Original languageEnglish (US)
Pages (from-to)369-374
Number of pages6
JournalMuscle and Nerve
Issue number3
StatePublished - Sep 2013


  • Clinical trial
  • Diabetic sensorimotor polyneuropathy
  • Nerve conduction
  • Proficiency
  • Standard reference value

ASJC Scopus subject areas

  • Physiology
  • Clinical Neurology
  • Cellular and Molecular Neuroscience
  • Physiology (medical)


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