Abstracts

Rationale Research informs us that in expert hands, the EEG is a useful investigative tool. Unfortunately it can also yield misleading information. In the UK, most EEG requests come from non-specialists. Further, it is usually doctors with have no specific training in neurology or neurophysiology who report most EEGs. We report the first completed audit of the utility of the EEG in clinical practice Methods The case notes and EEG reports were examined from 368 patients attending the Wrexham Maelor Hospital. A prospective audit, performed after dissemination of guidelines, involved review of 140 cases Results There were significant differences in requesting practice between clinicians. Non-specialists seem to use the EEG as a diagnostic tool, especially in patients with funny turns, where it is more likely to reveal non-specific abnormalities, open to misinterpretation, than clinically useful information. In the retrospective review, the proportion of EEGs considered to influence management, be justifiable and to be inappropriate were 16%, 28.3%, and 55.7% respectively. Following formation of guidelines, a significant change in practice was observed: in particular, there was a reduction in the total number of requests submitted (chi-squared = 24.95, d.f. = 5, p=0.001) mainly attributable to fewer requests regarding patients with funny turns (chi-squared = 13.6, d.f. =2, p=0.001) Conclusions This successful audit has potential benefits for patients and clinicians within the setting of a local neurophysiology service. Wider systematic application of this project could have significant cost implications for other health services