Please use this identifier to cite or link to this item: https://hdl.handle.net/20.500.12104/67496
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dc.contributor.authorChiquete, E.
dc.contributor.authorMiranda-Munoz, A.
dc.contributor.authorCastaneda-Moreno, V.
dc.contributor.authorVargas-Sanchez, A.
dc.contributor.authorGarcia-Llamas, L.
dc.contributor.authorOchoa-Guzman, A.
dc.contributor.authorRabago-Cervantes, R.
dc.contributor.authorZuniga-Ramirez, C.
dc.contributor.authorGonzalez-Jaime, J.
dc.contributor.authorRuiz-Sandoval, J.L.
dc.date.accessioned2015-11-19T18:52:14Z-
dc.date.available2015-11-19T18:52:14Z-
dc.date.issued2011
dc.identifier.urihttp://hdl.handle.net/20.500.12104/67496-
dc.description.abstractIntroduction: The carpal tunnel syndrome (CTS) is the most frequent compression neuropathy of the upper limbs. This condition may pose difficulties in diagnosis, given the subjectivity of most of their clinical manifestations. Aim: To design a clinical prediction rule that can improve the performance of physical examination in identifying cases with CTS. Methods: A case-control study was performed on patients who were referred to electrodiagnostic testing (here the gold standard) for suspicion of CTS. Bivariate analyses were performed on clinical manifestations and antecedents to select those with the best diagnostic performance and to integrate a clinical prediction rule. Results: A total of 72 patients were analyzed: 40 cases with confirmed CTS (90% women, mean age 50.2 years) and 32 controls with negative electrophysiological tests (84% women, mean age 40.6 years). Hand paresthesias (97 vs. 77%, p = 0.01), positive Phalen's test (67 vs. 27%, p = 0.001), positive Tinel sign (72 vs. 33%, p = 0.002) and age ≥ 50 (65 vs. 34%, p = 0.01) were more common among CTS cases than in controls. Thus, the presence of ≥ 2 of these characteristics had a sensitivity of 97% (95% CI: 86-100%), specificity of 50% (95% CI: 33-67%), positive predictive value of 70% (95% CI: 56-81%), negative predictive value of 94% (95% CI: 71-100%), and accuracy of 74% (95% CI: 61-86%). Conclusion: Age > 50 years, hand paresthesias, positive Phalen's test, and positive Tinel sign are variables strongly associated with CTS. The presence of ≥ 2 clinical characteristics has adequate performance in identifying suspicious cases, and their absence correctly exclude false positives.
dc.titleClinical prediction rule for diagnosis of the carpal tunnel syndrome [Regla clínica para el diagnostico del síndrome del túnel del carpo]
dc.typeArticle
dc.relation.ispartofjournalRevista Mexicana de Neurociencia
dc.relation.ispartofvolume12
dc.relation.ispartofissue3
dc.subject.keywordCarpal tunnel syndrome; Clinical prediction rule; Compression neuropathy; Diagnosis
dc.contributor.affiliationChiquete, E., Departamento de Medicina Interna, Hospital Civil de Guadalajara Fray Antonio Alcalde, Guadalajara, Mexico; Miranda-Muñoz, A., Departamento de Rehabilitación Física, Hospital Civil de Guadalajara Fray Antonio Alcalde, Guadalajara, Mexico; Castañeda-Moreno, V., Departamento de Neurología, Hospital Civil de Guadalajara Fray Antonio Alcalde, Guadalajara, Mexico; Vargas-Sánchez, Á., Departamento de Neurología, Hospital Civil de Guadalajara Fray Antonio Alcalde, Guadalajara, Mexico; García-Llamas, L., Departamento de Medicina Interna, Hospital Civil de Guadalajara Fray Antonio Alcalde, Guadalajara, Mexico; Ochoa-Guzmán, A., Departamento de Neurología, Hospital Civil de Guadalajara Fray Antonio Alcalde, Guadalajara, Mexico; Rábago-Cervantes, R., Departamento de Rehabilitación Física, Hospital Civil de Guadalajara Fray Antonio Alcalde, Guadalajara, Mexico; Zúñiga-Ramírez, C., Departamento de Neurología, Hospital Civil de Guadalajara Fray Antonio Alcalde, Guadalajara, Mexico; González-Jaime, J., Departamento de Rehabilitación Física, Hospital Civil de Guadalajara Fray Antonio Alcalde, Guadalajara, Mexico; Ruiz-Sandoval, J.L., Departamento de Neurología, Hospital Civil de Guadalajara Fray Antonio Alcalde, Guadalajara, Mexico, Departamento de Neurociencias, CUCS, Universidad de Guadalajara, Guadalajara, Mexico
dc.relation.isReferencedByScopus
dc.identifier.urlhttp://www.scopus.com/inward/record.url?eid=2-s2.0-79960513822&partnerID=40&md5=fd357eda61dde9a6f593b2b9725e8781
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