Quality of electrodiagnostic testing for carpal tunnel syndrome: adherence to quality measures

Muscle Nerve. 2020 Jul;62(1):50-59. doi: 10.1002/mus.26858. Epub 2020 Apr 27.


Introduction: Research has shown that quality of health-care services is often suboptimal. Little is known about the quality of electrodiagnostic testing.

Methods: We prospectively recruited 477 adults with workers' compensation claims for carpal tunnel syndrome (CTS) from 30 occupational health clinics and evaluated whether electrodiagnostic testing adhered to five process-oriented quality measures.

Results: Among patients who had surgery for CTS, nearly all underwent recommended preoperative electrodiagnostic testing (measure #1, 170 of 174, 97.7%). Most electrodiagnostic tests included essential components (measure #2, 295 of 379, 77.8%). However, few reports documented skin temperature (measure #3, 93 of 379, 24.5%) and criteria were seldom met for interpreting test findings as consistent with CTS (measure #4, 41 of 284, 14.4%) or "severe" CTS (measure #5, 8 of 46, 17.4%).

Discussion: Most patients underwent testing before surgery, but test quality was often suboptimal. This work lays the groundwork for future efforts to monitor and improve the quality of electrodiagnostic testing for CTS.

Keywords: carpal tunnel syndrome; electrodiagnosis; occupational diseases; quality measures; quality of care.

Publication types

  • Multicenter Study
  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, Non-P.H.S.
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adult
  • Carpal Tunnel Syndrome / diagnosis*
  • Carpal Tunnel Syndrome / physiopathology*
  • Cohort Studies
  • Electrodiagnosis / methods
  • Electrodiagnosis / standards*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Neural Conduction / physiology
  • Prospective Studies
  • Quality Indicators, Health Care / standards*
  • Surveys and Questionnaires