title: Hand-held nerve conduction device in carpal tunnel syndrome: a prospective study.
abstract: BACKGROUND
  We assessed the clinical impact of replacing standard neurophysiologic testing with a hand-held device (Mediracer) for diagnosis of carpal tunnel syndrome (CTS).
  
  
  METHODS
  One hundred patients (200 hands) with suspected CTS were studied by blinded assessors [Hand-therapist (HT)1 and Consultant Neurophysiologist] using the Mediracer, followed by standard neurophysiologic testing. To simulate testing by personnel without neurological training, Mediracer recordings were analyzed separately by an assessor who had not seen the patients (HT2).
  
  
  RESULTS
  Correlation of the CTS grades was 0.94 for the results obtained by HT1, and 0.87 for HT2. The sensitivity and specificity of the Mediracer was 0.85 and 0.9, respectively, by HT1, and 0.84 and 0.89 for HT2. Nine patients had conditions other than CTS, and 35 patients were judged to require further investigation.
  
  
  CONCLUSIONS
  The Mediracer should only be used in patients with typical CTS symptoms and signs and no muscle wasting who have had careful neurological assessment.
authors.affiliation: Department of Neurology and Clinical Neurophysiology, St Thomas' Hospital, Guy's and St Thomas' Foundation NHS Trust, Lambeth Palace Road, London, United Kingdom. veronica.tan@gstt.nhs.uk
authors.forename: S Veronica
authors.initials: SV
authors.lastname: Tan
authors.forename: Fiona
authors.initials: F
authors.lastname: Sandford
authors.forename: Mark
authors.initials: M
authors.lastname: Stevenson
authors.forename: Sara
authors.initials: S
authors.lastname: Probert
authors.forename: Sue
authors.initials: S
authors.lastname: Sanders
authors.forename: Kerry R
authors.initials: KR
authors.lastname: Mills
authors.forename: Michaelis
authors.initials: M
authors.lastname: Koutroumanidis
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D002349:Carpal Tunnel Syndrome / Q000175:diagnosis* / Q000503:physiopathology; D004558:Electric Stimulation / Q000295:instrumentation / Q000379:methods; D005260:Female; D006225:Hand; D006801:Humans; D008297:Male; D008875:Middle Aged; D009431:Neural Conduction / Q000502:physiology*; D009460:Neurologic Examination / Q000295:instrumentation* / Q000379:methods*; D011446:Prospective Studies; D012720:Severity of Illness Index; D013223:Statistics as Topic; D055815:Young Adult