Chua Marcel, Seth Ishith, Rozen Warren M
Central Clinical School, Monash University, Melbourne, VIC, Australia.
Monash Doctors Workforce, Monash Health, Clayton, VIC, Australia.
Hand Ther. 2024 Jun;29(2):44-51. doi: 10.1177/17589983241230249. Epub 2024 Jan 28.
The Ten Test (TT) is a touch threshold test that quantifies sensory discrimination by comparing an injured area with a contralateral uninjured area. It's quick, simple, equipment-free and repeatable. However, as a subjective measure, the TT's reliability and applicability need further investigation. This review aimed to investigate if the TT has superior inter- and intra-examiner reliability compared to the widely accepted Weinstein Enhanced Sensory Test (WEST) in a human population of all ages.
A systematic search was conducted on major databases from January 1997 to September 2023 and adhered to the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocol. Outcomes were assessed with a narrative approach. The included articles were critically appraised according to the Quality Assessment of Diagnostic Accuracy Studies two tool.
This review included five articles. High inter-examiner reliability was demonstrated with intraclass correlation coefficient (ICC) values of 0.91 and 0.95, alongside a kappa statistic of 1, as reported by three distinct studies. Intra-examiner reliability displayed some variance, with one study reporting a significant ICC value in four out of six instances. Two studies corroborated that the TT results corresponded with the findings of WEST, each presenting a Spearman rank coefficient of -0.71.
Our findings underscore the TT's high inter-examiner reliability, though its intra-examiner reliability exhibited some inconsistencies. Interestingly, certain studies claimed its superiority over the WEST. To validate the TT's use in the clinical setting, more rigorous studies, particularly those comparing pre-operative TT outcomes with intraoperative nerve damage evaluations, are essential.
十项试验（TT）是一种触觉阈值测试，通过将受伤区域与对侧未受伤区域进行比较来量化感觉辨别能力。它快速、简单、无需设备且可重复。然而，作为一种主观测量方法，TT的可靠性和适用性需要进一步研究。本综述旨在调查在所有年龄段的人群中，与广泛接受的温斯坦增强感觉测试（WEST）相比，TT是否具有更高的检查者间和检查者内可靠性。
对1997年1月至2023年9月的主要数据库进行了系统检索，并遵循系统评价和Meta分析方案的首选报告项目。采用叙述性方法评估结果。根据诊断准确性研究质量评估二工具对纳入的文章进行严格评价。
本综述纳入了五篇文章。三项不同的研究报告显示，组内相关系数（ICC）值分别为0.91和0.95，kappa统计值为1，表明检查者间可靠性较高。检查者内可靠性存在一些差异，一项研究报告在六个实例中的四个实例中ICC值显著。两项研究证实TT结果与WEST的结果一致，每项研究的斯皮尔曼等级系数均为-0.71。
我们的研究结果强调了TT的检查者间可靠性较高，尽管其检查者内可靠性存在一些不一致。有趣的是，某些研究称其优于WEST。为了验证TT在临床环境中的应用，需要进行更严格的研究，特别是那些将术前TT结果与术中神经损伤评估进行比较的研究。
