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.
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.
Authors: Francesco S Violante; Roberta Bonfiglioli; Lucia Isolani; Giovanni B Raffi Journal: Int Arch Occup Environ Health Date: 2004-11-05 Impact factor: 3.015
Authors: F S Violante; R Bonfiglioli; F Graziosi; A Caso; L Isolani; C Fiorentini; S Mattioli Journal: Occup Environ Med Date: 2006-09-14 Impact factor: 4.402
Authors: Regina M Taylor-Gjevre; John A Gjevre; Lannae Strueby; Carol A J Boyle; Bindu Nair; John T Sibley Journal: Can Fam Physician Date: 2007-07 Impact factor: 3.275
Authors: Ann Marie Dale; Carisa Harris-Adamson; David Rempel; Fred Gerr; Kurt Hegmann; Barbara Silverstein; Susan Burt; Arun Garg; Jay Kapellusch; Linda Merlino; Matthew S Thiese; Ellen A Eisen; Bradley Evanoff Journal: Scand J Work Environ Health Date: 2013-02-19 Impact factor: 5.024