title: Interobserver agreement in case history evaluation in carpal tunnel syndrome.
abstract: OBJECTIVE
  The case history is the cornerstone for the diagnosis of carpal tunnel syndrome (CTS). The value of neurological examination in CTS seems limited. In this study, we investigated the interobserver agreement in case history of CTS and the potential additional value of neurological examination.
  
  
  METHODS
  Case history was taken and neurological examination was done in all patients referred for a possible CTS during a 6-month period. This was done independently by 2 senior neurologists.
  
  
  RESULTS
  We studied 119 patients. The interobserver agreement for the conclusion of CTS after history was high (k = 0.79). Neurological examination rarely changed the diagnosis based on the case history.
  
  
  CONCLUSIONS
  This study shows a high interobserver agreement in the diagnosis of CTS based on patient history alone. Neurological examination rarely changed this diagnosis, suggesting a prominent role for the case history and a limited role for neurological examination. This may have practical implications.
authors.affiliation: Department of Neurology, Albert Schweitzer Hospital, Dordrecht, the Netherlands.
authors.forename: Dewa
authors.initials: D
authors.lastname: Westerman
authors.forename: Henk
authors.initials: H
authors.lastname: Kerkhoff
authors.forename: Gerhard H
authors.initials: GH
authors.lastname: Visser
authors.forename: Rudolf P
authors.initials: RP
authors.lastname: Kleyweg
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002349:Carpal Tunnel Syndrome / Q000145:classification / Q000175:diagnosis* / Q000503:physiopathology; D003657:Decision Making; D003937:Diagnosis, Differential; D004558:Electric Stimulation; D004568:Electrodiagnosis; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009431:Neural Conduction / Q000502:physiology*; D009460:Neurologic Examination; D011930:Reaction Time; D012189:Retrospective Studies; D011795:Surveys and Questionnaires; D055815:Young Adult