The analysis of sensitivity, specificity, positive predictive value and negative predictive value of cold provocation thermography in the objective diagnosis of the hand-arm vibration syndrome.
The diagnosis of digital artery vasospasm in the hand-arm vibration syndrome (HAVS) is clinically based, and the need for an accurate objective test to support the diagnosis has been highlighted. This study aims to analyse the potential of cold provocation thermography (CPT) to fulfill this role. CPT was performed on two groups of subjects: 10 controls and 21 patients with Raynaud's phenomenon (RP) secondary to HAVS. After taking a pre-cooling image, patients donned latex gloves and immersed their hands in water at a temperature of 5 degrees C for 1 min. The patients removed their hands from the water and discarded the gloves, and further images were taken every 30 s for 10 min. On each image, the temperatures of the tip and base were analysed for each digit. The sensitivity, specificity, positive and negative predictive values for fingertip temperatures only, fingertip and fingerbase temperatures combined, and fingertip temperature, fingerbase temperature and temperature gradient combined were determined. Patients with RP secondary to HAVS demonstrated significantly lower finger tip and base temperatures and lower digital temperature gradients at all time intervals when compared with controls (P < 0.01, Student's t-test). CPT has good sensitivity, specificity, positive predictive value and negative predictive value; it strongly supports the clinical diagnosis of digital vasospasm.
Coughlin
P A
PA
Department of Vascular and Endovascular Surgery, St. James's and Seacroft University Hospitals, Leeds LS9 7TF, UK. pacoughlin@aol.com
Chetter
I C
IC
Kent
P J
PJ
Kester
R C
RC
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001132:Arm; D003080:Cold Temperature; D005260:Female; D005385:Fingers / Q000098:blood supply; D006225:Hand; D006801:Humans; D008297:Male; D008875:Middle Aged; D016272:Occupational Health; D011237:Predictive Value of Tests; D011928:Raynaud Disease / Q000175:diagnosis / Q000209:etiology; D012680:Sensitivity and Specificity; D013577:Syndrome; D013817:Thermography / Q000379:methods; D014652:Vascular Diseases / Q000175:diagnosis* / Q000209:etiology; D014732:Vibration / Q000009:adverse effects*