Evaluation of a Symptom Diagram for Identifying Carpal Tunnel Syndrome

Details

• Personal Author:
  Bonauto DK ; Fan ZJ ; Silverstein BA ; Smith CK ; Wilcox DN
• Description:
  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. [Description provided by NIOSH]
• Subjects:
  Biomechanical Phenomena Epidemiology Ergonomics Musculoskeletal Diseases Musculoskeletal System Occupational Health Safety
• Keywords:
  Author Keywords: Carpal Tunnel Syndrome Biological-function Biological-monitoring Biomechanical-modeling Biomechanics Electrochemical-analysis Epidemiological Studies Motion-studies Musculoskeletal Musculoskeletal-system Musculoskeletal-system-disorders Nerve-function Neurological-reactions Posture Screening Standards Statistical-analysis Testing-equipment Work-analysis Work-performance Work-practices

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• ISSN:
  0962-7480
• Document Type:
  Text
• Funding:
  Cooperative Agreement
• Genre:
  Journal Article
• Place as Subject:
  OSHA Region 10 ; Washington
• CIO:
  National Institute for Occupational Safety and Health (NIOSH)
• Topic:
  Workplace Safety & Health
• Location:
  North America
• Volume:
  58
• Issue:
  8
• NIOSHTIC Number:
  nn:20035995
• Citation:
  Occup Med 2008 Dec; 58(8):561-566
• Contact Point Address:
  David K. Bonauto, SHARP Program, Washington State Department of Labor and Industries, PO Box 44330, Olympia, WA 98504-4330
• Email:
  bone235@lni.wa.gov
• Federal Fiscal Year:
  2009
• NORA Priority Area:
  Disease and Injury: Musculoskeletal Disorders of the Upper Extremities
• Performing Organization:
  Washington State Department of Labor and Industries
• Peer Reviewed:
  True
• Start Date:
  20000930
• Source Full Name:
  Occupational Medicine
• End Date:
  20060929
• Collection(s):
  National Institute for Occupational Safety and Health
• Main Document Checksum:
  urn:sha-512:cad57b15343ffcea997755310700726c2590a1c69ae1c97c17cabefcf01dd31785569eba5d2715866244db7cde22d0d74dd92bcc34b8885961d00ecb04124516
• Download URL:
  https://stacks.cdc.gov/view/cdc/187628/cdc_187628_DS1.pdf
• File Type:
  [PDF - 108.24 KB ]