Neurology Tools: Usage Frequency (P06.023)

Abstract

Objective: We looked how frequently examining tools are used in neurology clinics in a tertiary hospital. Background Doing a proper and complete neurological examination is the key in localization, reaching a diagnosis and devising an appropriate management plan. We simply looked at three clinical examination tools: T endon Hammer (T), O phthalmoscope (O) and S tethoscope(S). Design/Methods: We prospectively collected TOS data in a single blinded fashion by interviewing the patient after they have been seen in neurology clinic at King Fahad Medical City. We looked at patient demographics, type of appointment (new vs. follow-up) and the neurological diagnosis and then correlated to TOS usage. Results: We collected 100 patients over a period of 2 weeks, in October, 2011. There were 54 female, mean (+ SD) age 38.4(+16.6) years, and 46 male aged 44.6(+20.7) years. There were 12 new and 88 follow-up patients, who were seen by different neurologists. They had varied diagnosis (Neuromuscular-26, Seizure-25, Stroke-23, Headache-11, Multiple Sclerosis-10, Dementia-4, Spinal Disc disease-1 patients). We looked at TOS- Disease specific usage in Neuromuscular disease (T-54%, O-27%, S-0%), Seizures (T-40%, O-36%, S-16%), Stroke patients (T-35%, O-20%, S-0%), Multiple Sclerosis (T-30%, O-50%, S-0), and Dementia (T-50%, O-25%, S-25%). Out of 12 new patients 83% had Tendon hammer and 41% had Ophthalmoscope used and none had Stethoscope. In follow-up patients 32% had Tendon Hammer, 31% had Ophthalmoscope and 6% had Stethoscope used. Thus, overall Tendon hammer was used in 42%, Ophthalmoscope in 33% and Stethoscope in 5% of the patients. Conclusions: Tendon Hammer and Ophthalmoscope were used in evaluation of majority of new patients, while only one third of the follow-up patients had these tools utilized. Declining trend in using of TOS tools is probably not a good sign and may affect the quality of patient care. Disclosure: Dr. Nahrir has nothing to disclose. Dr. AlSinaidi has nothing to disclose. Dr. Siddiqui has nothing to disclose. Dr. Sinha has nothing to disclose. Dr. Nicholls has nothing to disclose. Dr. Siddiqui has nothing to disclose.