Effects of Varying Case Definition on Carpal Tunnel Syndrome Prevalence Estimates in a Pooled Cohort

• DOI: 10.1016/j.apmr.2014.08.004
• Publication Date: 2014-08-28T12:51:11Z
• Authors: Matthew S. Thiese; Fred Gerr; Kurt T. Hegmann; Carisa Harris-Ada...; Ann Marie Dale; Bradley Evanoff; Ellen A. Eisen; Jay Kapellusch; Arun Garg; Susan Burt; Stephen Bao; Barbara Silverstein; Linda Merlino; David Rempel
• Keywords: Adult; Male; Standards; Clinical Sciences; Health Care Sector; Neurodegenerative; 7.3 Management and decision making; 03 medical and health sciences; 0302 clinical medicine; Clinical Research; Diagnostic techniques and procedures; Manufacturing Industry; Prevalence; Reaction Time; Humans; Peripheral Neuropathy; Carpal tunnel syndrome; Ulnar Nerve; Electrodiagnosis; Pain Research; Rehabilitation; Construction Industry; Neurosciences; Human Movement and Sports Sciences; Middle Aged; Carpal Tunnel Syndrome; Occupational Injuries; Median Nerve; Public Health and Health Services; Female; Management of diseases and conditions; Chronic Pain

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.Pooled data from 5 prospective cohorts.Hand-intensive industrial settings, including manufacturing, assembly, production, service, construction, and health care.Employed, working-age participants who are able to provide consent and undergo EDS testing (N=3130).None.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.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.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.