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

Abstract

The following article refers to this text: 2011;37(4):259-358

Reliability of Hand Diagrams for the Epidemiologic Case Definition of Carpal Tunnel Syndrome

“…Patients seeking medical attention may bias physician ratings of a hand diagram, increasing the sensitivities found in past studies [17,22]. Work and general population studies have shown less ability to predict nerve conduction abnormalities from hand diagram results with a wide range of sensitivity (0.19-0.90) and specificity (0.39-0.95) [5,26,27].…”

“…Similarly, general population based studies have shown a broad range of sensitivity and specificity values [5,[25][26][27]. Despite varying validity, reliability has shown consistently high results with kappa and intraclass correlation coefficients of 0.89 to 0.93 [24,25].…”

“…The prevalence of this disorder has been estimated between one and five percent in the general population [1][2][3] with higher estimated rates of 10% or more reported among workers in some industries [4][5][6]. The direct costs for treatment and indirect costs for lost work time and permanent functional disability make this syndrome costly for patients as well as employers [7,8].…”

“…Varying the electrodiagnostic cut points for an abnormal classification will also alter the number of cases. Physical examination findings, though commonly employed, have shown poor validity and reliability in epidemiological settings [5,[17][18][19][20][21].…”

Síndrome do túnel do carpo: controvérsias a respeito de diagnóstico clínico e eletrofisiológico e a relação com o trabalho

“…Em um estudo de trabalhadores 17 , sintomas de STC desenvolveram-se em em 12% dos trabalhadores com condução sensitiva do mediano aumentada e em 10% dos trabalhadores com condução sensitiva normal, durante um seguimento de 10 a 24 meses. A concordância entre sintomas, exame físico e alterações eletrofisiológicas é baixa, tendo Homan et al 18 encontrado uma concordância de 5% entre os três parâmetros e Atroshi et al 9 encontraram 2,7%. Um exame eletrodiagnóstico positivo na ausência de sintomas não pode ser considerado diagnóstico de STC 6 .…”