title: Lack of predictive power of the "tethered" median stress test in suspected carpal tunnel syndrome.
abstract: OBJECTIVE
  To investigate the value of the "tethered" median nerve stress test (TMST) in predicting electrodiagnostically confirmed carpal tunnel syndrome (CTS) in patients with symptoms suggestive of CTS.
  
  
  METHODS
  Blinded comparison of a clinical diagnostic test with neurophysiologic testing.
  
  
  METHODS
  Portland (OR) Veterans Administration Medical Center Electrodiagnostic Laboratory.
  
  
  METHODS
  One hundred two consecutive patients referred for symptoms suggestive of CTS. Study inclusion criteria were referral for evaluation of symptoms of paresthesia (with or without pain) inclusive of the median nerve distribution distal to the wrist.
  
  
  RESULTS
  Fifty-seven percent of referred patients had electrodiagnostically confirmed CTS. The sensitivity of the TMST was 50%. The specificity was 59.1%. The positive predictive value was 61.7%. The negative predictive value was 47.3%.
  
  
  CONCLUSIONS
  The TMST does not have utility in predicting electrodiagnostic consult results in veteran patients with symptoms suggestive of CTS.
authors.affiliation: The Department of Physical Medicine and Rehabilitation, Portland Veterans Administration Medical Center, OR, USA.
authors.forename: M P
authors.initials: MP
authors.lastname: Kaul
authors.forename: K J
authors.initials: KJ
authors.lastname: Pagel
authors.forename: J D
authors.initials: JD
authors.lastname: Dryden
mesh_terms: D000328:Adult; D002349:Carpal Tunnel Syndrome / Q000175:diagnosis*; D004568:Electrodiagnosis; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D012680:Sensitivity and Specificity