Thomsen J F, Mikkelsen S
Department of Occupational Medicine, Glostrup Hospital, University of Copenhagen, DK-2600 Glostrup, Denmark.
Occup Med (Lond). 2003 Feb;53(1):57-63. doi: 10.1093/occmed/kqg010.
In most epidemiological studies on carpal tunnel syndrome (CTS), the case definition is based on questionnaire data with or without neurophysiological testing. The aim of this study was to test if the use of questionnaire data results in misclassification of cases.
In two studies, involving 940 and 311 participants, respectively, the people indicating CTS symptoms (tingling) in a questionnaire were clinically interviewed. In a subpopulation (n = 404), all went through an interview regardless of their questionnaire answers.
Only 35-45% of the participants reporting tingling once a week or more in the questionnaire actually had symptoms consistent with CTS when interviewed. The remaining 55-65% had no or infrequent symptoms or symptoms because of other disorders. Few potential CTS cases were missed. The positive predictive values were 0.48 (95% CI = 0.30-0.66) and 0.52 (95% CI = 0.38-0.67) on the right and left hands, respectively. The sensitivities, specificities and negative predictive values ranged from 0.87 to 1.00.
Questionnaire information overestimates the prevalence of CTS symptoms. However, asking about tingling in a questionnaire is a simple and sensitive first step to detect potential CTS cases, but symptoms should be confirmed by interview.
在大多数关于腕管综合征（CTS）的流行病学研究中，病例定义基于有无神经生理学检测的问卷数据。本研究的目的是检验使用问卷数据是否会导致病例误分类。
在两项分别涉及940名和311名参与者的研究中，对在问卷中表明有CTS症状（刺痛）的人进行了临床访谈。在一个亚组（n = 404）中，无论问卷答案如何，所有人都接受了访谈。
在问卷中报告每周刺痛一次或更多次的参与者中，只有35%-45%在接受访谈时实际有与CTS相符的症状。其余55%-65%没有症状或症状不频繁，或者是由其他疾病引起的症状。很少有潜在的CTS病例被漏诊。右手和左手的阳性预测值分别为0.48（95%CI = 0.30-0.66）和0.52（95%CI = 0.38-0.67）。敏感性、特异性和阴性预测值范围为0.87至1.00。
问卷信息高估了CTS症状的患病率。然而，在问卷中询问刺痛是检测潜在CTS病例的简单且敏感的第一步，但症状应通过访谈来确认。
