Predicting the Outcome of Nerve Conduction Studies in Patients with Suspected Carpal Tunnel Syndrome: Using an Existing Carpal Tunnel Assessment Tool


This service evaluation and pilot study was designed to establish whether a clinical questionnaire could be incorporated within our Secondary Care Carpal Tunnel Service. The purpose of the questionnaire is to predict the positive and negative results of Nerve Conduction Studies (NCS) in those patients with suspected Carpal Tunnel Syndrome. The hand specialist, preceding NCS administered the questionnaire; it was then scored at a later date. Results showed a sensitivity of 86% and specificity of 84% referring to the ability to predict a positive NCS when using a predetermined cut-off score. When analysed with Receiver Operating Characteristics, a threshold score could be determined in order to obtain 100% sensitivity/specificity. This questionnaire can be used as a useful adjunct to assessment of those presenting with suspected Carpal Tunnel Syndrome. Using the questionnaire to identify those patients scoring outside a predetermined threshold range would reduce the need for NCS by nearly 50%, with significant cost and clinical practice implications.

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Edwards, C. and Frampton, I. (2014) Predicting the Outcome of Nerve Conduction Studies in Patients with Suspected Carpal Tunnel Syndrome: Using an Existing Carpal Tunnel Assessment Tool. Open Journal of Therapy and Rehabilitation, 2, 57-62. doi: 10.4236/ojtr.2014.22010.

Conflicts of Interest

The authors declare no conflicts of interest.


[1] Khu, K.J., Bernstein, M. and Midha, R. (2011) Patients Perception of Carpal Tunnel and Ulnar Nerve Decompression Surgery. Canadian Journal of Neurological Sciences, 38, 268-273.
[2] Luchetti, R. and Amadio, P. (2007) Carpal Tunnel Syndrome. Springer, Berlin.
[3] Conolly, W.B. and McKessar, J.H. (2009) Carpal Tunnel Syndrome—Can It Be a Work Related Condition? Australian Family Physician, 38, 684-686.
[4] Patijn, J., Vallejo, R., Janssen, M., Huygen, F., Lataster, A., van Kleef, M. and Mekhail, N. (2011) Carpal Tunnel Syndrome. Pain Practice, 11, 297-301.
[5] Petiot, P. and Bernard, E. (2011) Diagnostic Pitfalls in Carpal Tunnel Syndrome. Revue Neurologique (Paris), 167, 64-71.
[6] Descatha, A., Dale, A.M., Franzblau, A., Coomes, J. and Evanoff, B. (2010) Diagnostic Strategies Using Physical Examination Are Minimally Useful in Defining Carpal Tunnel Syndrome in Population-Based Research Studies. Occupational and Environmental Medicine, 67, 133-135.
[7] Strickland, J.W. and Gozani, S.N. (2011) Accuracy of In-Office Nerve Conduction Studies for Median Nerve: A Meta-Analysis. Journal of Hand Surgery, 36, 52-60.
[8] Levine, D.W., Simmons, B.P., Koris, M.J., Daltroy, L.H., Hohl, G.G., Fossel, A.H. and Katz, J.N. (1993) A Self-Administered Questionnaire for the Assessment of Symptoms and Functional Status in Carpal Tunnel Syndrome. The Journal of Bone and Joint Surgery, 75, 1585-1592.
[9] Kamath, V. and Stothard, J. (2003) A Clinical Questionnaire for the Diagnosis of Carpal Tunnel Syndrome. The Journal of Hand Surgery, 28, 455-459.
[10] Katz, J.N., Stirrat, C.R., Larson, M.G., Fossel, A.H., Eaton, H.M. and Liang, M.H. (1990) A Self-Administered Hand Symptom Diagram for the Diagnosis and Epidemiologic Study of Carpal Tunnel Syndrome. Journal of Rheumatology, 17, 1495-1498.
[11] Bridges, M.J., Robertson, D.C. and Chuck, A.J. (2011) Predicting the Result of Nerve Conduction Studies in Carpal Tunnel Syndrome Using a Questionnaire. Hand Surgery, 16, 39-42.
[12] Bahrmann, A., Zieschang, T., Neumann, T., Hein, G. and Oster, P. (2010) Carpal Tunnel Syndrome in Diabetes Mellitus. Medizinische Klinik, 105, 150-154. ( in German)
[13] Gazioglu, S., Boz, C. and Cakmak, V.A. (2011) Electrodiagnosis of Carpal Tunnel Syndrome in Patients with Diabetic Polyneuropathy. Clinical Neurophysiology, 122, 1463-1469.
[14] Fombonne, E. and Fuhrer, R. (1992) Use of ROC Analysis in Psychiatry. Encephale, 18, 545-550. (in French)

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