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

Matthew S. Thiese, Fred Gerr, Kurt T. Hegmann, Carisa Harris-Adamson, Ann Marie Dale, Bradley Evanoff, Ellen A. Eisen, Jay Kapellusch, Arun Garg, Susan Burt, Stephen Bao, Barbara Silverstein, Linda Merlino, David Rempel

Research output: Contribution to journalArticlepeer-review

26 Scopus citations

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 nerveeserved 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.

Original languageEnglish
Pages (from-to)2320-2326
Number of pages7
JournalArchives of Physical Medicine and Rehabilitation
Volume95
Issue number12
DOIs
StatePublished - 2014

Keywords

  • Carpal tunnel syndrome
  • Diagnostic techniques and procedures
  • Electrodiagnosis
  • Prevalence
  • Rehabilitation
  • Standards

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