改良 Phalen 试验辅助诊断腕管综合征。

Modified Phalen's test as an aid in diagnosing carpal tunnel syndrome.

机构信息

Internal Medicine, Reeves County Hospital, Pecos, Texas 79772, USA.

出版信息

Arthritis Care Res (Hoboken). 2012 Feb;64(2):287-9. doi: 10.1002/acr.20664.

DOI:10.1002/acr.20664

PMID:21972217

Abstract

OBJECTIVE

We developed a modified Phalen's test (MPT), which uses sensory testing in Phalen's position, as a diagnostic screening tool for carpal tunnel syndrome (CTS). This study was designed to determine the sensitivity, specificity, and receiver operating characteristic (ROC) curve of the MPT for diagnosis of CTS.

METHODS

Electrodiagnostic nerve conduction studies (EDS) were used as the gold standard. MPT was performed by a blinded examiner on patients prior to EDS. MPT was recorded as either positive or negative based on the presence or absence of a median nerve sensory deficit while the hand was in Phalen's position.

RESULTS

Sixty-six hands were included in this study. Chi-square for the MPT compared to EDS as the gold standard was 41.449 (P < 0.001), and the validity coefficient (phi) was 0.792 (P < 0.01). The traditional Phalen's test (TPT) compared to the EDS demonstrated a chi-square of 15.349 (P < 0.001) and a phi coefficient of 0.482 (P < 0.01). ROC curve estimates for the MPT revealed a sensitivity of 84.4% compared to 50% for the TPT. The standard error of the estimate for sensitivity was 3.3% for the MPT and 5.8% for the TPT.

CONCLUSION

The MPT is a highly useful screening diagnostic tool for CTS. The MPT demonstrates greater accuracy than the TPT for predicting CTS. The MPT also demonstrates greater sensitivity than the TPT in predicting a positive electrodiagnostic test for CTS.

摘要

目的

我们开发了一种改良的 Phalen 试验（MPT），它在 Phalen 位置进行感觉测试，作为腕管综合征（CTS）的诊断筛查工具。本研究旨在确定 MPT 诊断 CTS 的敏感性、特异性和受试者工作特征（ROC）曲线。

方法

电诊断神经传导研究（EDS）用作金标准。在进行 EDS 之前，由盲法检查者对患者进行 MPT。根据手处于 Phalen 位置时正中神经感觉缺失的存在与否，将 MPT 记录为阳性或阴性。

结果

本研究共纳入 66 只手。与 EDS 作为金标准相比，MPT 的卡方检验为 41.449（P < 0.001），有效性系数（phi）为 0.792（P < 0.01）。传统的 Phalen 试验（TPT）与 EDS 相比，卡方检验为 15.349（P < 0.001），phi 系数为 0.482（P < 0.01）。MPT 的 ROC 曲线估计显示，与 TPT 的 50%相比，MPT 的敏感性为 84.4%。MPT 敏感性的估计标准误差为 3.3%，TPT 的估计标准误差为 5.8%。