The effectiveness of post-offer pre-placement nerve conduction screening for carpal tunnel syndrome

Ann Marie Dale, Bethany T. Gardner, Angelique Zeringue, Robert Werner, Alfred Franzblau, Bradley Evanoff

Research output: Contribution to journalArticle

4 Scopus citations

Abstract

Objective: We evaluated post-offer pre-placement (POPP) nerve conduction studies (NCS) for carpal tunnel syndrome (CTS), testing diagnostic yield and cost-effectiveness. Methods: A total of 1027 newly hired workers underwent baseline NCS and were followed for an average of 3.7 years for diagnosed CTS. Measures of diagnostic yield included sensitivity, specificity, and positive predictive value (PPV). Cost-effectiveness of POPP screening was evaluated using a range of inputs. RESULTS:: Abnormal NCS was strongly associated with future CTS with univariate hazard ratios ranging from 2.95 to 11.25, depending on test parameters used. Nevertheless, PPV was poor, 6.4% to 18.5%. Cost-effectiveness of POPP varied with CTS case costs, screening costs, and NCS thresholds. Conclusions: Although abnormal NCS at hire increases risk of future CTS, the PPV is low, and POPP screening is not cost-effective to employers in most scenarios tested.

Original languageEnglish
Pages (from-to)840-847
Number of pages8
JournalJournal of occupational and environmental medicine
Volume56
Issue number8
DOIs
StatePublished - Aug 2014

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