How Well Are We Adhering to National Peripheral Neuropathy Diagnostic Guidelines?

For patients suspected of having distal symmetric peripheral neuropathy, the 2009 American Academy of Neurology (AAN) guidelines recommend fasting glucose and vitamin B12 testing and serum protein electrophoresis (SPEP), with impaired glucose tolerance test (GTT) for patients without evidence of diabetes on routine testing; and use of clinical judgement for additional laboratory studies. They do not recommend routine electrodiagnostic testing (EMG) for typical diabetic neuropathy and magnetic resonance imaging (MRI) for peripheral neuropathy. To assess concordance with the guidelines, researchers examined 2019 Medicare claims data for randomly identified adults with an incident peripheral neuropathy diagnosis enrolled in Medicare.

Among near…