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Agreement between symptom surveys, physical examination procedures and electrodiagnostic findings for the carpal tunnel syndrome.

Authors
Homan-MM; Franzblau-A; Werner-RA; Albers-JW; Armstrong-TJ; Bromberg-MB
Source
Scand J Work, Environ & Health 1999 Apr; 25(2):115-124
NIOSHTIC No.
20030018
Abstract
OBJECTIVES: The goal of this study was to evaluate the concordance between various clinical screening procedures for carpal tunnel syndrome. METHODS: The subject population consisted of 824 workers from 6 facilities. The evaluated procedures included bilateral sensory nerve conduction testing, physical examinations, and symptom surveys, including hand diagrams. The agreement between the outcomes of various combinations of these procedures was assessed by determining the kappa coefficient. RESULTS: There was relatively poor overlap between the reported symptoms, the physical examination findings, and the electrodiagnostic results consistent with carpal tunnel syndrome. Overall, only 23 out of 449 subjects (5%) with at least 1 positive finding met all 3 criteria (symptoms, physical examination findings, and electrophysiological results consistent with carpal tunnel syndrome) for the dominant hand. The screening procedures showed poor or no agreement with kappa values ranging between 0.00 and 0.18 for all the case definitions evaluated for carpal tunnel syndrome. CONCLUSIONS: The poor overlap between the various screening procedures warns against the use of electrodiagnostic findings alone without the symptom presentation being considered. The results of this study also point to a need for the further development and evaluation of methods for detecting carpal tunnel syndrome.
Keywords
Musculoskeletal-system-disorders; Musculoskeletal-system; Repetitive-work; Cumulative-trauma-disorders; Cumulative-trauma; Carpal-tunnel-syndrome; Hand-injuries; Ergonomics
Contact
Department of Environmental and Industrial Health, University of Michigan School of Public Health, Ann Arbor 48109-2029
CODEN
SWEHDO
Publication Date
19990401
Document Type
Journal Article
Funding Amount
610264
Funding Type
Grant
Fiscal Year
1999
NTIS Accession No.
NTIS Price
Identifying No.
Grant-Number-R01-OH-002941
ISSN
0355-3140
Priority Area
Grants Other
Source Name
Scandinavian Journal of Work, Environment and Health
State
MI
Performing Organization
University of Michigan, School of Public Health, Ann Arbor, MI
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