Or one of my pet peeves, waveforms described as “positive sharp waves” (indicative of nerve root injury) that are actually motor end plate potentials, a normal finding. For example, CTS was recognized but never quantified so that the referring physician would be unable to determine evidence based treatment based on the actual severity of nerve entrapment.
An additional problem when waveforms were available for review, was to find multiple ‘technical’ errors, the most common being the failure to recognize abnormal motor and sensory amplitudes indicative of axonal neuropathy, or incorrect nerve latencies where the latency marker was over an abnormal baseline easily recognized as 60-cycle interference, or missing a reduced motor amplitude indicative of axonal damage due to focal entrapment neuropathy. It is appalling to find conclusions not supported by the data provided, or worse yet, the correct diagnosis ignored when the data clearly supported a specific diagnosis. I had to agree after a brief review of sample reports. This provider complained that the studies were often equivocal or conclusions vague without much definitive information to help with treatment decisions. I had a recent conversation with a physician asking why EMG/NCV should be ordered on most patients presenting to a chronic pain practice.
