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
Grant-Number-R01-OH-009712; Grant-Number-T42-CCT-810426; Grant-Number-T42-OH-008429; Grant-Number-T42-OH-008491
Archives of Physical Medicine and Rehabilitation
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University of California-San Francisco