Doctors are more likely to use high-cost MRI scans to diagnose peripheral neuropathy than cheaper-and more effective-glucose tolerance tests, a recent US study has found.
In people with peripheral neuropathy, the nerves that carry information to and from the brain don't work properly. Symptoms of the disorder include tingling, burning or less feeling in the arms or legs, and can range from mild to severe.
Diabetes is the most common cause of peripheral neuropathy, which affects about 15% of those over age 40.
When diagnosing peripheral neuropathy, doctors differ greatly in what tests they turn to, researchers at the University of Michigan noted in their study, published in the Archives of Internal Medicine.
"We spend a lot of money to work up a diagnosis of neuropathy. The question is whether the money is well spent," said study leader Brian Callaghan, MD, assistant professor of neurology at the University of Michigan Medical School.
Study Details
Dr. Callaghan and his colleagues analyzed data from the 1996-2007 US Health and Retirement Study to identify patients diagnosed with peripheral neuropathy. The researchers focused on 15 diagnostic tests and looked at the number and patterns of tests six months before and after diagnosis.
The investigators found that nearly one-quarter of patients underwent MRIS, while very few (about 196) had a simpler, less expensive glucose tolerance test, which is used to determine if someone has diabetes by measuring how well the body responds to sugar (glucose).
"Our findings, that MRIs were frequently ordered by physicians, 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," Dr. Callaghan said.
Implications
"Currently no standard approach to the evaluation of peripheral neuropathy exists. We need more research to determine an optimal approach," he added.
