Ana Torres-Costoso1, Vicente Martínez-Vizcaíno2, Celia Álvarez-Bueno3, Asunción Ferri-Morales1, Iván Cavero-Redondo4. 1. Universidad de Castilla-La Mancha, School of Nursing and Physiotherapy, Toledo, Spain. 2. Universidad de Castilla-La Mancha, Health and Social Research Center, Cuenca, Spain; Universidad Autónoma de Chile, Facultad de Ciencias de la Salud, Talca, Chile. 3. Universidad de Castilla-La Mancha, Health and Social Research Center, Cuenca, Spain. Electronic address: Celia.AlvarezBueno@uclm.es. 4. Universidad de Castilla-La Mancha, Health and Social Research Center, Cuenca, Spain.
Abstract
OBJECTIVE: To evaluate the accuracy of inlet and outlet ultrasonography measurements for the diagnosis of carpal tunnel syndrome (CTS). DATA SOURCES: MEDLINE, EMBASE, the Cochrane Library, and the Web of Science databases were systematically searched from inception to February 2017. STUDY SELECTION: Observational studies comparing the diagnostic accuracy of inlet and outlet ultrasonography measurements were selected. DATA EXTRACTION: Random-effects models for the diagnostic odds ratio (dOR) values computed by Moses' constant for a linear model and 95% confidence intervals (CIs) were used to calculate the accuracy of the test. Hierarchical summary receiver operating characteristic curves were used to summarize overall test performance. DATA SYNTHESIS: Twenty-eight published studies were included in the meta-analysis. The pooled dOR values for the diagnosis of CTS were 31.11 (95% CI, 20.42-47.40) for inlet-level and 16.94 (95% CI, 7.58-37.86) for outlet-level measurements. The 95% confidence region for the point that summarizes overall test performance of the included studies occurred where the cutoffs ranged from 9.0 to 12.6mm2 for inlet-level measurements and from 9.5 to 10.0mm2 for outlet-level measurements. CONCLUSIONS: Both ultrasonography measurements for the diagnosis of CTS showed sufficient accuracy for their use in clinical settings, although the overall accuracy was slightly higher for inlet-level than for outlet-level measurements. The addition of outlet and inlet measurements does not increase the accuracy for the diagnosis. Therefore, the inlet-level ultrasonography measurement appears to be an appropriate method for the diagnosis of CTS.
OBJECTIVE: To evaluate the accuracy of inlet and outlet ultrasonography measurements for the diagnosis of carpal tunnel syndrome (CTS). DATA SOURCES: MEDLINE, EMBASE, the Cochrane Library, and the Web of Science databases were systematically searched from inception to February 2017. STUDY SELECTION: Observational studies comparing the diagnostic accuracy of inlet and outlet ultrasonography measurements were selected. DATA EXTRACTION: Random-effects models for the diagnostic odds ratio (dOR) values computed by Moses' constant for a linear model and 95% confidence intervals (CIs) were used to calculate the accuracy of the test. Hierarchical summary receiver operating characteristic curves were used to summarize overall test performance. DATA SYNTHESIS: Twenty-eight published studies were included in the meta-analysis. The pooled dOR values for the diagnosis of CTS were 31.11 (95% CI, 20.42-47.40) for inlet-level and 16.94 (95% CI, 7.58-37.86) for outlet-level measurements. The 95% confidence region for the point that summarizes overall test performance of the included studies occurred where the cutoffs ranged from 9.0 to 12.6mm2 for inlet-level measurements and from 9.5 to 10.0mm2 for outlet-level measurements. CONCLUSIONS: Both ultrasonography measurements for the diagnosis of CTS showed sufficient accuracy for their use in clinical settings, although the overall accuracy was slightly higher for inlet-level than for outlet-level measurements. The addition of outlet and inlet measurements does not increase the accuracy for the diagnosis. Therefore, the inlet-level ultrasonography measurement appears to be an appropriate method for the diagnosis of CTS.
Authors: Reza Salman Roghani; Mohammad Taghi Holisaz; Ali Asghar Sahami Norouzi; Ahmad Delbari; Faeze Gohari; Johan Lokk; Andrea J Boon Journal: J Pain Res Date: 2018-07-10 Impact factor: 3.133