Abstract Details

A Clinical Effectiveness Study of Visual Evoked Potentials at a Tertiary Neurology Unit

A retrospective study of visual evoked potentials (VEP) was performed at St George’s hospital -a tertiary neurology centre in South West London.  As part of the NHS referral to treatment target of 18 weeks, the local target to complete investigations from referral is 6 weeks.   The aim of the study was to determine the effectiveness of the referrals pathway and to identify any areas for improvement.

Data from the 100 of the most recent (up to May 2015) completed referral forms was extracted. 

98 patients were referred for VEP with or without additional tests (SSEP, BAEP) in the preceding 13 months. Two referrals contained insufficient information.  A small majority were female (n=50). A peak in referrals between the ages of 21 and 30 was noted, with 25% of patients in this group. The referrals were assigned to one of seven broad clinical questions; 1 - MS/demyelination/optic neuritis, 2 – optic neuropathy, 3 – brain injury, 4 – seizures, 5 – unexplained/functional visual loss, 6 – retinopathy, 7 – other/unknown. Half of the referrals asked about MS, with assessment of anoxic brain injury the next most common question. 26 patients waited longer than 42 days, including 15 with new symptoms of MS. Private patients overall waited less than half the time of NHS patient. 

This study highlighted the following - firstly, clinicians are most commonly referring women in their 20s to what is now considered to be a second-line test.   And secondly, referrals are often patchy in quality and frequently delayed between date of referral and date of receipt in the Neurophysiology department.  This was partly due to differences in Trust referral forms and clerical systems.  These issues are now being addressed.

TitleForenamesSurnameInstitutionLead AuthorPresenter
DrStuartMannUniversity Hospitals Bristol
DrAraniNitkunanSt George's
DrFredSchonCroydon University Hospital
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