title: Systematic review and meta-analysis on the work-related cause of de Quervain tenosynovitis: a critical appraisal of its recognition as an occupational disease.
abstract: BACKGROUND
  The authors systematically reviewed all of the etiopathologic factors discussed in the literature to verify the classification of de Quervain tenosynovitis on the list of occupational diseases.
  
  
  METHODS
  The authors searched Ovid MEDLINE, EMBASE, and the Cochrane Library for articles discussing the cause of de Quervain tenosynovitis. The literature was classified by the level of evidence presented, the etiopathologic hypothesis discussed, the authors' conclusion about the role of the etiopathologic hypothesis, and the first author's professional background. The quality of reporting of the observational studies was evaluated by an extended Strengthening the Reporting of Observational Studies in Epidemiology statement checklist. A meta-analysis of all controlled cohort studies was performed. The Bradford Hill criteria were used to evaluate a causal relationship between de Quervain tenosynovitis and occupational risk factors.
  
  
  RESULTS
  A total of 179 references were found, and 80 articles were included. On average, only 35 percent (median, 35 percent; range, 16 to 60 percent) of all items on the extended Strengthening the Reporting of Observational Studies in Epidemiology checklist were addressed per article. The meta-analysis to evaluate the strength of the association between de Quervain tenosynovitis and (1) repetitive, (2) forceful, or (3) ergonomically stressful manual work suggested an odds ratio of 2.89 (95 percent CI, 1.4 to 5.97; p = 0.004). No evidence was found to support the Bradford Hill criteria for a causal relationship between de Quervain tenosynovitis and occupational risk factors.
  
  
  CONCLUSIONS
  No sufficient scientific evidence was provided to confirm a causal relationship between de Quervain tenosynovitis and occupational risk factors.
  
  
  METHODS
  Risk, III.
authors.affiliation: Tübingen and Stuttgart, Germany From the Department of Plastic, Hand, and Reconstructive Surgery, Burn Center, BG-Trauma Center, and the Institute for Clinical Epidemiology and Applied Biometry, Eberhard-Karl University of Tübingen; and the Department for Plastic Surgery, Marienhospital Stuttgart.
authors.forename: Stéphane
authors.initials: S
authors.lastname: Stahl
authors.forename: Daniel
authors.initials: D
authors.lastname: Vida
authors.forename: Christoph
authors.initials: C
authors.lastname: Meisner
authors.forename: Oliver
authors.initials: O
authors.lastname: Lotter
authors.forename: Jens
authors.initials: J
authors.lastname: Rothenberger
authors.forename: Hans-Eberhard
authors.initials: HE
authors.lastname: Schaller
authors.forename: Adelana Santos
authors.initials: AS
authors.lastname: Stahl
mesh_terms: D053684:De Quervain Disease / Q000175:diagnosis* / Q000453:epidemiology / Q000209:etiology*; D006801:Humans; D009784:Occupational Diseases / Q000150:complications* / Q000175:diagnosis* / Q000453:epidemiology; D015995:Prevalence; D012307:Risk Factors; D013717:Tenosynovitis / Q000175:diagnosis* / Q000453:epidemiology / Q000209:etiology*