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Carpal compression test and pressure provocative test in veterans with median‐distribution paresthesias
Author(s) -
Kaul Matthew P.,
Pagel Keith J.,
Wheatley Michael J.,
Dryden John D.
Publication year - 2001
Publication title -
muscle and nerve
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.025
H-Index - 145
eISSN - 1097-4598
pISSN - 0148-639X
DOI - 10.1002/1097-4598(200101)24:1<107::aid-mus14>3.0.co;2-8
Subject(s) - carpal tunnel syndrome , medicine , gold standard (test) , predictive value of tests , cohort , predictive value , positive predicative value , prospective cohort study , population , carpal tunnel , cohort study , surgery , environmental health
Abstract We investigated the value of the carpal compression test (CCT) and the pressure provocative test (PPT) in predicting carpal tunnel syndrome (CTS) in a predominantly male population of veterans. We performed a prospective, blinded comparison of these clinical diagnostic tests with neurophysiological testing. One cohort of 135 consecutive patients was assessed with the CCT; a separate cohort of 134 consecutive patients was assessed with the PPT. Of these 269 patients, 58.4% had electrodiagnostically confirmed CTS. The sensitivity of the CCT was 52.5%, specificity was 61.8%, positive predictive value was 66.6%, and the negative predictive value was 47.2%. The sensitivity of the PPT was 54.5%, specificity was 68.4%, positive predictive value was 70%, and the negative predictive value was 52.7%. The CCT and PPT had minimal utility in predicting electrodiagnostically confirmed CTS. In a subset of the CCT cohort, 86 consecutive veterans were also evaluated in relation to a clinical gold standard. Of these patients, 60% had CTS based on this gold standard. CCT sensitivity was 53.8%, specificity was 61.8%, positive predictive value was 68.3%, and negative predictive value was 46.7%. The CCT thus had marginal utility in predicting CTS based on a clinical gold standard. © 2001 John Wiley & Sons, Inc. Muscle Nerve 24: 107–111, 2001