The AANEM Foundation has committed over $245,000 to a project developed by principal investigator, Dr. Teryl Nuckols, and her team from the RAND Corporation, evaluating the quality of electrodiagnostic (EDX) studies in patients with suspected carpal tunnel syndrome (CTS). This is the single largest project funded by the AANEM Foundation to date. The project, “The Value of High Quality Medical Care for Work-Associated Carpal Tunnel Syndrome”, began in August 2016, with completion planned for the end of 2018. “In the current environment of having to prove quality, this study is key for the future for our members,” noted Dr. Vincent Tranchitella, who spearheaded the project while serving as AANEM President in 2014-15. “We are hoping this study shows that quality EDX studies for the diagnosis of CTS will improve clinical outcomes and lower economic costs.”
The study’s key aims are:
To assess the quality of EDX studies for the diagnosis of CTS in the workers’ compensation setting
To examine the relationship between the quality of EDX studies and clinical outcomes for patients with suspected CTS
To examine the relationship between the quality of EDX studies and the appropriateness and utilization of surgery, total healthcare expenditures for CTS, and time on temporary disability
This project builds on a large prospective, observational research study that examined the quality of care for work-associated CTS. This study documented variations in the quality of the initial evaluation, non-operative treatment, the appropriateness of surgery, and the assessment and management of activities that exacerbate CTS symptoms. Having a positive EDX study was associated with receiving significantly higher quality care. This study is also examining the relationship between quality and clinical outcomes, healthcare utilization, expenditures, and time on temporary disability.
Published literature indicates that the costs of work- related CTS appear higher than the costs of other work-related injuries: CTS leads to more than four times as many days away from work as the average nonfatal work-related injury, and accounts for more than half of the workers’ compensation costs for upper extremity disorders. In 2006, U.S. workers compensation claims totaled $26.5 billion for medical costs, with $28.2 billion in benefits paid. “Our hope is that the RAND study will help us prove the value of electrodiagnostic testing as part of the care of CTS, avoiding overuse of EDX testing, but establishing when it is an appropriate test. Evaluating outcomes of care processes is a key part of the value-based transformation of health care,” stated Pushpa Narayanaswami, Chair of the AANEM’s Quality Measures Committee.
The RAND Corporation is a nonprofit institution that helps improve policy and decision making through research and analysis. RAND Health seeks to improve health and health care around the world. The mission of the AANEM Foundation is the promotion and advancement of neuromuscular and EDX education and scientific research and the promotion of health for patients with neuromuscular diseases. Through this collaboration, the AANEM Foundation hopes to provide a positive outcome for EDX physicians and their patients.
Read more about AANEM’s currently funded research projects at www.aanemfoundation.org/projects