Effects of varying case definition on carpal tunnel syndrome prevalence estimates in a pooled cohort

Arch Phys Med Rehabil. 2014 Dec;95(12):2320-6. doi: 10.1016/j.apmr.2014.08.004. Epub 2014 Aug 28.

Abstract

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.

Keywords: Carpal tunnel syndrome; Diagnostic techniques and procedures; Electrodiagnosis; Prevalence; Rehabilitation; Standards.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adult
  • Carpal Tunnel Syndrome / diagnosis*
  • Carpal Tunnel Syndrome / epidemiology*
  • Carpal Tunnel Syndrome / physiopathology
  • Construction Industry
  • Electrodiagnosis*
  • Female
  • Health Care Sector
  • Humans
  • Male
  • Manufacturing Industry
  • Median Nerve / physiopathology
  • Middle Aged
  • Occupational Injuries / diagnosis*
  • Occupational Injuries / epidemiology*
  • Prevalence
  • Reaction Time
  • Ulnar Nerve / physiopathology