title: Effects of varying case definition on carpal tunnel syndrome prevalence estimates in a pooled cohort.
abstract: OBJECTIVE
  To analyze differences in carpal tunnel syndrome (CTS) prevalence using a combination of electrodiagnostic studies (EDSs) and symptoms using EDS criteria varied across a range of cutpoints and compared with symptoms in both ≥1 and ≥2 median nerve-served digits.
  
  
  METHODS
  Pooled data from 5 prospective cohorts.
  
  
  METHODS
  Hand-intensive industrial settings, including manufacturing, assembly, production, service, construction, and health care.
  
  
  METHODS
  Employed, working-age participants who are able to provide consent and undergo EDS testing (N=3130).
  
  
  METHODS
  None.
  
  
  METHODS
  CTS prevalence was estimated while varying the thresholds for median sensory latency, median motor latency, and transcarpal delta latency difference. EDS criteria examined included the following: median sensory latency of 3.3 to 4.1 milliseconds, median motor latency of 4.1 to 4.9 milliseconds, and median-ulnar sensory difference of 0.4 to 1.2 milliseconds. EDS criteria were combined with symptoms in ≥1 or ≥2 median nerve-served digits. EDS criteria from other published studies were applied to allow for comparison.
  
  
  RESULTS
  CTS prevalence ranged from 6.3% to 11.7%. CTS prevalence estimates changed most per millisecond of sensory latency compared with motor latency or transcarpal delta. CTS prevalence decreased by 0.9% to 2.0% if the criteria required symptoms in 2 digits instead of 1.
  
  
  CONCLUSIONS
  There are meaningful differences in CTS prevalence when different EDS criteria are applied. The digital sensory latency criteria result in the largest variance in prevalence.
authors.affiliation: Rocky Mountain Center for Occupational and Environmental Health, University of Utah, Salt Lake City, UT. Electronic address: matt.thiese@hsc.utah.edu.
authors.forename: Matthew S
authors.initials: MS
authors.lastname: Thiese
authors.affiliation: Department of Occupational and Environmental Health, College of Public Health, University of Iowa, Iowa City, IA.
authors.forename: Fred
authors.initials: F
authors.lastname: Gerr
authors.affiliation: Rocky Mountain Center for Occupational and Environmental Health, University of Utah, Salt Lake City, UT.
authors.forename: Kurt T
authors.initials: KT
authors.lastname: Hegmann
authors.affiliation: Department of Physical Therapy, Samuel Merritt University, Oakland, CA.
authors.forename: Carisa
authors.initials: C
authors.lastname: Harris-Adamson
authors.affiliation: Division of General Medical Science, Washington University School of Medicine, Saint Louis, MO.
authors.forename: Ann Marie
authors.initials: AM
authors.lastname: Dale
authors.affiliation: Division of General Medical Science, Washington University School of Medicine, Saint Louis, MO.
authors.forename: Bradley
authors.initials: B
authors.lastname: Evanoff
authors.affiliation: Department of Environmental Health Sciences, University of California Berkeley, Berkeley, CA.
authors.forename: Ellen A
authors.initials: EA
authors.lastname: Eisen
authors.affiliation: Center for Ergonomics, University of Wisconsin-Milwaukee, Milwaukee, WI.
authors.forename: Jay
authors.initials: J
authors.lastname: Kapellusch
authors.affiliation: Center for Ergonomics, University of Wisconsin-Milwaukee, Milwaukee, WI.
authors.forename: Arun
authors.initials: A
authors.lastname: Garg
authors.affiliation: National Institute for Occupational Safety and Health, Cincinnati, OH.
authors.forename: Susan
authors.initials: S
authors.lastname: Burt
authors.affiliation: Safety and Health Assessment and Research for Prevention Program, Washington State Department of Labor and Industries, Olympia, WA.
authors.forename: Stephen
authors.initials: S
authors.lastname: Bao
authors.affiliation: Safety and Health Assessment and Research for Prevention Program, Washington State Department of Labor and Industries, Olympia, WA.
authors.forename: Barbara
authors.initials: B
authors.lastname: Silverstein
authors.affiliation: Department of Occupational and Environmental Health, College of Public Health, University of Iowa, Iowa City, IA.
authors.forename: Linda
authors.initials: L
authors.lastname: Merlino
authors.affiliation: Division of Occupational and Environmental Medicine, University of California at San Francisco, San Francisco, CA.
authors.forename: David
authors.initials: D
authors.lastname: Rempel
mesh_terms: D000328:Adult; D002349:Carpal Tunnel Syndrome / Q000175:diagnosis* / Q000453:epidemiology* / Q000503:physiopathology; D060389:Construction Industry; D004568:Electrodiagnosis; D005260:Female; D019981:Health Care Sector; D006801:Humans; D008297:Male; D066192:Manufacturing Industry; D008475:Median Nerve / Q000503:physiopathology; D008875:Middle Aged; D060051:Occupational Injuries / Q000175:diagnosis* / Q000453:epidemiology*; D015995:Prevalence; D011930:Reaction Time; D014459:Ulnar Nerve / Q000503:physiopathology
keywords: Carpal tunnel syndrome; Diagnostic techniques and procedures; Electrodiagnosis; Prevalence; Rehabilitation; Standards