Electrodiagnostic testing and carpal tunnel release outcome

Glowacki, Keith A.; Breen, Christopher J.; Sachar, Kavi; Weiss, Arnold‐Peter C.

doi:10.1016/s0363-5023(96)80164-x

Cited by 115 publications

(68 citation statements)

References 19 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…In our study, the clinical assessment [15,[34][35][36][37][38] was followed by ultrasonography and/or NCS study, and only 55.7% of cases were eventually defined as the CTS-confirmed cases, suggesting that the clinical estimates may be biased by a significant overdiagnosis. As previously reported, despite the general reliance on NCS/electromyography as diagnostic gold standards, when electrodiagnostic tests are performed in order to validate the results of the physical exams, they are potentially biased by the clinical diagnosis and its inherent variability [52,53]. In other terms, an even more cautious approach is required not only when comparing our results to national estimates but also when referring to similar studies [2,3,10,[18][19][20][23][24][25][26][27].…”

Section: Discussionmentioning

confidence: 78%

“…Finally, it should be stressed that a clear consensus about the best clinical criteria for diagnosis of the CTS still does not exist [35,51,52]. In our study, the clinical assessment [15,[34][35][36][37][38] was followed by ultrasonography and/or NCS study, and only 55.7% of cases were eventually defined as the CTS-confirmed cases, suggesting that the clinical estimates may be biased by a significant overdiagnosis.…”

Section: Discussionmentioning

confidence: 90%

See 1 more Smart Citation

Personal and occupational risk factors for carpal tunnel syndrome in meat processing industry workers in Northern Italy

Riccò

Signorelli

2017

Med Pr

View full text Add to dashboard Cite

Background: Carpal tunnel syndrome (CTS) is a musculoskeletal condition that often impairs the fitness to work. Our aim is to retrospectively evaluate the association between physical exposures in meat processing industry in Northern Italy and the CTS, taking into account non-occupational factors. Material and Methods: A cross-sectional study was performed to include 434 workers (236 males, 198 females, 37.0±10.6 years old, working age: 12.6±10.8 years) from meat processing industries. Signs and symptoms were collected at the compulsory occupational medical surveillance. Occupational risk factors were assessed through a questionnaire and direct assessment by investigators. Adjusted odds ratios (ORadj) for factors of interest were estimated through binary logistic regression. Results: Diagnosis of the CTS was reported for 61 out of 434 subjects (14.1%) for an incidence of 11.3/1000 person-years. In general, signs and symptoms for the CTS were associated with the following demographic factors: smoking history (OR = 1.909, 95% confidence interval (CI): 1.107-3.293), previous traumas of the upper limb (OR = 3.533, 95% CI: 1.743-7.165), hypothyroidism status (OR = 7.897, 95% CI: 2.917-21.38) and, in the case of female participants only, previous pregnancies (OR = 2.807, 95% CI: 1.200-6.566) as well as a personal history of oral contraceptive therapy and/or steroidal replacement therapy (OR = 11.57, 95% CI: 4.689-28.56). The carpal tunnel syndrome cases were associated with the following occupational factors (> 4 h/day): forceful hand exertion (ORadj = 3.548, 95% CI: 1.379-9.131), repeated trauma of the hand (ORadj = 3.602, 95% CI: 1.248-10.395), repeated movements of the wrist (ORadj = 2.561, 95% CI: 1.100-5.960). Conclusions: Increasing levels of hand activity and force were associated with the increased CTS prevalence among participants. Recommendations have to be provided in order to reduce occupational exposure to these risk factors and improve medical surveillance. Med Pr 2017;68(2) :199-209

show abstract

Section: Discussionmentioning

confidence: 78%

Section: Discussionmentioning

confidence: 90%

Personal and occupational risk factors for carpal tunnel syndrome in meat processing industry workers in Northern Italy

Riccò

Signorelli

2017

Med Pr

View full text Add to dashboard Cite

show abstract

“…The operationalization of the criteria is available from the authors on request laterally treated, number of patients or hands randomised), interventions (type, treatment schedule), outcome measures, timing of the follow-up measurements, and results (point estimates and measures of variability, number of patients or hands). Although data on all reported outcomes were extracted, outcome measures on symptoms (e. g. pain, percentage of patients with improved symptoms) were considered as primary outcomes, because these are of the greatest importance for patients [23,27]. Information on side-effects was also recorded.…”

Section: Methods S Search and Selection Of Studiesmentioning

confidence: 99%

Conservative treatment options for carpal tunnel syndrome: a systematic review of randomised controlled trials

Gerritsen¹,

Krom

Struijs³

et al. 2002

Journal of Neurology

185

122

View full text Add to dashboard Cite

“…The charge assigned to a false-positive test was meant to penalize a confirmatory test for incorrectly diagnosing CTS. The determination of a falsepositive test in clinical practice may be difficult and hard to confirm, as successful surgery for CTS release is an imperfect measure because patient symptoms often are multifactorial and all symptoms may not improve with surgery [5,10]. We did not attempt to quantify the legal and ethical costs of performing surgery for an incorrect diagnosis (false-positive test).…”

Section: Discussionmentioning

confidence: 99%

Ultrasound as a First-line Test in the Diagnosis of Carpal Tunnel Syndrome: A Cost-effectiveness Analysis

Fowler

Maltenfort

Ilyas

2013

Clinical Orthopaedics &Amp; Related Research

View full text Add to dashboard Cite

Background The American Academy of Orthopaedic Surgeons (AAOS) recommends that surgeons obtain a confirmatory test in patients for whom carpal tunnel surgery is being considered. The AAOS, however, does not specify a preferred test. Ultrasound reportedly causes less patient discomfort and takes less time to perform, while maintaining comparable sensitivity and specificity to electrodiagnostic testing (EDX). Questions/purposes We determined whether ultrasound as a first-line diagnostic test is more cost-effective than using EDX alone or using ultrasound alone: (1) when used by a general practitioner; and (2) when used by a specialist. Methods A fictional population of patients was created and each patient was randomly assigned a probability of having true-positive, false-positive, true-negative, and truepositive ultrasound and EDX tests over an expected range of sensitivity and specificity values using Monte Carlo methods. Charges were assigned based on Medicare charges for diagnostic tests and estimates of missed time from work. Results The average charge for the use of ultrasound as a first-line diagnostic test followed by EDX for confirmation of a negative ultrasound test was $562.90 per patient in the general practitioner scenario and $369.50 per patient in the specialist scenario, compared with $400.30 and $428.30 for EDX alone, respectively. Conclusions The use of diagnostic ultrasound as a firstline test for confirmation of a clinical diagnosis of carpal tunnel syndrome is a more cost-effective strategy in the specialist population and results in improved false-negative rates in the generalist population despite increased cost. Level of Evidence Level III, economic and decision analyses. See the Guidelines for Authors for a complete description of levels of evidence.

show abstract

Electrodiagnostic testing and carpal tunnel release outcome

Cited by 115 publications

References 19 publications

Personal and occupational risk factors for carpal tunnel syndrome in meat processing industry workers in Northern Italy

Personal and occupational risk factors for carpal tunnel syndrome in meat processing industry workers in Northern Italy

Conservative treatment options for carpal tunnel syndrome: a systematic review of randomised controlled trials

Ultrasound as a First-line Test in the Diagnosis of Carpal Tunnel Syndrome: A Cost-effectiveness Analysis

Contact Info

Product

Resources

About