PMID- 18796697
OWN - NLM
STAT- MEDLINE
DCOM- 20091005
LR  - 20191210
IS  - 1471-8405 (Electronic)
IS  - 0962-7480 (Linking)
VI  - 58
IP  - 8
DP  - 2008 Dec
TI  - Evaluation of a symptom diagram for identifying carpal tunnel syndrome.
PG  - 561-6
LID - 10.1093/occmed/kqn123 [doi]
AB  - BACKGROUND: Hand symptom diagrams (HSDs) for rating the distribution of 
      paraesthesias are proposed for use in epidemiological studies of carpal tunnel 
      syndrome (CTS). AIM: To assess the validity of HSDs in a working population of 
      manufacturing and service workers participating in a prospective study of 
      musculoskeletal disorders. METHODS: Assessment of each subject involved 
      completing a HSD, a heath assessment and electrodiagnostic studies (EDSs). HSDs 
      were rated for CTS blinded to the health assessment and EDS results. The validity 
      assessments of HSD used EDS as the sole confirmatory standard for CTS. RESULTS: A 
      total of 733 subjects (65% of those eligible) participated in the study and 720 
      underwent EDSs. Dominant hand prevalence of a positive HSD and delayed nerve 
      conduction studies in this working population was 9.2 per 100 workers. The 
      sensitivity of a positive HSD for all workers was 0.28. By restricting the 
      population to those workers with any current hand symptoms or to any worker with 
      neuropathic hand symptoms, the sensitivities of HSD improved to 0.61 and 0.79, 
      respectively. The positive predictive value of a HSD, with our study prevalence, 
      was 0.48. CONCLUSIONS: The HSD classification schema has poor validity when 
      applied to a general working population but improves when applied to workers with 
      current neuropathic symptoms. The high number of false-negative HSDs in the 
      general study population is most likely to be due to the inadequacies of using 
      EDS as the confirmatory test. With a low prevalence of CTS, the positive 
      predictive value for HSDs is poor.
FAU - Bonauto, David K
AU  - Bonauto DK
AD  - Safety and Health Assessment and Research for Prevention (SHARP) Program, 
      Washington State Department of Labor and Industries, Olympia, WA 98504-4330, USA. 
      bone235@lni.wa.gov
FAU - Silverstein, Barbara A
AU  - Silverstein BA
FAU - Fan, Z Joyce
AU  - Fan ZJ
FAU - Smith, Caroline K
AU  - Smith CK
FAU - Wilcox, Dana N
AU  - Wilcox DN
LA  - eng
GR  - U01 OH07316/OH/NIOSH CDC HHS/United States
PT  - Evaluation Study
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PT  - Research Support, U.S. Gov't, P.H.S.
DEP - 20080916
PL  - England
TA  - Occup Med (Lond)
JT  - Occupational medicine (Oxford, England)
JID - 9205857
SB  - IM
MH  - Adolescent
MH  - Adult
MH  - Carpal Tunnel Syndrome/*diagnosis
MH  - Electrodiagnosis
MH  - Female
MH  - *Hand
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Neural Conduction
MH  - Occupational Diseases/*diagnosis
MH  - Prospective Studies
MH  - Sensitivity and Specificity
MH  - Young Adult
EDAT- 2008/09/18 09:00
MHDA- 2009/10/06 06:00
CRDT- 2008/09/18 09:00
PHST- 2008/09/18 09:00 [pubmed]
PHST- 2009/10/06 06:00 [medline]
PHST- 2008/09/18 09:00 [entrez]
AID - kqn123 [pii]
AID - 10.1093/occmed/kqn123 [doi]
PST - ppublish
SO  - Occup Med (Lond). 2008 Dec;58(8):561-6. doi: 10.1093/occmed/kqn123. Epub 2008 Sep 
      16.