Effects of varying case definition on carpal tunnel syndrome prevalence estimates in a pooled cohort.
Thiese-MS; Gerr-F; Hegmann-KT; Harris-Adamson-C; Dale-AM; Evanoff-B; Eisen-EA; Kapellusch-J; Garg-A; Burt-S; Bao-S; Silverstein-B; Merlino-L; Rempel-D
Arch Phys Med Rehabil 2014 Dec; 95(12):2320-2326
OBJECTIVE: To analyze differences in carpal tunnel syndrome (CTS) prevalence using a combination of electrodiagnostic studies (EDSs) and symptoms using EDS criteria varied across a range of cutpoints and compared with symptoms in both =1 and =2 median nerve-served digits. DESIGN: Pooled data from 5 prospective cohorts. SETTING: Hand-intensive industrial settings, including manufacturing, assembly, production, service, construction, and health care. PARTICIPANTS: Employed, working-age participants who are able to provide consent and undergo EDS testing (N=3130). INTERVENTIONS: None. MAIN OUTCOME MEASURES: CTS prevalence was estimated while varying the thresholds for median sensory latency, median motor latency, and transcarpal delta latency difference. EDS criteria examined included the following: median sensory latency of 3.3 to 4.1 milliseconds, median motor latency of 4.1 to 4.9 milliseconds, and median-ulnar sensory difference of 0.4 to 1.2 milliseconds. EDS criteria were combined with symptoms in =1 or =2 median nerve-served digits. EDS criteria from other published studies were applied to allow for comparison. RESULTS: CTS prevalence ranged from 6.3% to 11.7%. CTS prevalence estimates changed most per millisecond of sensory latency compared with motor latency or transcarpal delta. CTS prevalence decreased by 0.9% to 2.0% if the criteria required symptoms in 2 digits instead of 1. CONCLUSIONS: There are meaningful differences in CTS prevalence when different EDS criteria are applied. The digital sensory latency criteria result in the largest variance in prevalence.
Carpal-tunnel-syndrome; Diagnostic-techniques; Extremities; Hand-injuries; Nerve-function; Nerves; Musculoskeletal-system; Musculoskeletal-system-disorders; Humans; Men; Women; Workers; Sensory-disorders;
Author Keywords: Carpal tunnel syndrome; Diagnostic techniques and procedures; Electrodiagnosis; Prevalence; Rehabilitation; Standards
Matthew S. Thiese, PhD, MSPH, Rocky Mountain Center for Occupational and Environmental Health, University of Utah, 391Chipeta Way, Ste C, Salt Lake City, Utah 84108
Archives of Physical Medicine and Rehabilitation
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University of California-San Francisco