title: Rapid Screening for Carpal Tunnel Syndrome: A Novel Method and Comparison With Established Others.
abstract: OBJECTIVE
  The authors have observed that in healthy people, the Ulnar wrist-to-first dorsal interosseous distal motor latency does not differ significantly compared with median wrist-to-abductor pollicis brevis distal motor latency. The aim of our study was to investigate whether the difference between these two latencies can be used as a screening tool for diagnosing carpal tunnel syndrome and how this technique compares with other established techniques.
  
  
  METHODS
  The study was set up as a prospective observational study. As gold standard for the clinical diagnosis of carpal tunnel syndrome, the authors used the opinion of two neurologists who independently examined the patients. A third neurologist, also independently, performed the electrophysiological study.
  
  
  RESULTS
  Eighty-four subjects, 42 patients and 42 age- and sex-matched controls, participated in the study. Among all subjects using a receiver operating characteristic curve analysis, the area under the curve was 0.924 (95% CI, 0.857-0.991; SE, 0.034; P < 0.001). To detect carpal tunnel syndrome, at a cutoff score of equal to or greater than 0.575 milliseconds, our technique showed a sensitivity of 91%, a specificity of 93%, a positive predictive value of 93%, and a negative predictive value of 91%. Compared with other "classical" techniques, our technique showed better area under the receiver operating characteristic curve and better Youden index.
  
  
  CONCLUSIONS
  The median wrist-to-abductor pollicis brevis motor latency minus ulnar wrist-to-first dorsal interosseous motor latency may be used as a novel rapid screening tool of patients suffering from carpal tunnel syndrome.
authors.affiliation: *1st Department of Neurology, National and Kapodistrian University of Athens, Aeginition Hospital, Athens, Greece; and †Department of Neurology, Evangelismos General Hospital, Athens, Greece.
authors.forename: Panagiotis
authors.initials: P
authors.lastname: Zis
authors.forename: Vassilios
authors.initials: V
authors.lastname: Zis
authors.forename: Sophia
authors.initials: S
authors.lastname: Xirou
authors.forename: Elissavet
authors.initials: E
authors.lastname: Kemanetzoglou
authors.forename: Thomas
authors.initials: T
authors.lastname: Zambelis
authors.forename: Nikolaos
authors.initials: N
authors.lastname: Karandreas
mesh_terms: D000293:Adolescent; D000328:Adult; D002349:Carpal Tunnel Syndrome / Q000175:diagnosis*; D016022:Case-Control Studies; D004558:Electric Stimulation; D004568:Electrodiagnosis / Q000379:methods*; D005260:Female; D006225:Hand / Q000294:innervation; D006801:Humans; D008297:Male; D008475:Median Nerve / Q000502:physiology; D009431:Neural Conduction / Q000502:physiology*; D011446:Prospective Studies; D012372:ROC Curve; D011930:Reaction Time / Q000502:physiology*; D014459:Ulnar Nerve / Q000502:physiology; D014953:Wrist / Q000294:innervation; D055815:Young Adult