Background: Electroencephalography (EEG) is frequently requested for indications which do not have adequate supporting evidence and/or which are unlikely to lead to a change in patient management. We undertook a prospective study to examine the stated indications for EEG testing and whether the EEGs actually resulted in a change in patient management.

Method: A prospective audit of EEGs was performed at The Canberra Hospital between 12th February and 27th April, 2007. Two questionnaires were used. The first listed the main possible indications for the EEG and was completed by the requesting doctor at the time the EEG was requested. The second questionnaire was mailed to the referring doctor two weeks after the test asking wether the EEG had resulted in any change(s) in patient management.

Results: Sixty-nine EEGs were audited. Of these, 81% were requested for the diagnosis, classification or management of epilepsy. The next most common indications were investigation of confusion (22%) and syncope (14%). Neurologists and paediatricians accounted for 69% of all referrals. Only 27 of the 69 referring doctors responded to the second questionnaire. Of the respondents, 74% felt that the EEG was useful, but in only 19% was there an obvious change in management.

Conclusions: Many EEGs continue to be requested for reasons not supported by available evidence. This is reflected in the low incidence of changes in patient management. Reasons for this and strategies to optimise the use of EEG (e.g. education and guideline development) will be discussed.