Priya Ankita, Bansal Charu, Mangla Harshita, Shinde Manjusha, Ghosh Tandra
Department of Physiology, All India Institute of Medical Sciences (AIIMS), Kalyani, West Bengal, India.
J Family Med Prim Care. 2024 Nov;13(11):5047-5051. doi: 10.4103/jfmpc.jfmpc_541_24. Epub 2024 Nov 18.
Carpal Tunnel Syndrome (CTS) poses significant diagnostic challenges, especially in resource-limited settings. Reliable tools such as the 6-item Symptom Severity Index, Timed Phalen's Test (TPT) and CTS-6 are promising but under investigated. Correlation between these tools and symptom severity remains underexplored.
To correlate the 6-item Symptom Severity Index and CTS-6 diagnostic tool with TPT in clinically diagnosed CTS cases, evaluating their diagnostic performance.
Prospective cross-sectional study, conducted in a tertiary care hospital in eastern India. 105 patients were enrolled after fulfilling inclusion criteria, assessing them with the 6-item Symptom Severity Index, CTS-6 diagnostic tool and TPT. Pearson's and Spearman's correlation coefficients were used, and statistical significance was set at < 0.05.
Of 188 evaluated hands, TPT showed a significant negative correlation with CTS-6 scores (r = -0.59, < 0.0001), indicating lower scores with higher TPT values. CTS-6 scores positively correlated with symptom severity (r = 0.34, < 0.0001), indicating higher Symptom Severity Indices associated with increased diagnostic probability. Positive predictive value for TPT was 70.1%, with sensitivity of 83.7% and specificity of 61.1%. Symptom Severity Indexing demonstrated higher sensitivity (100%) but lower specificity (3.3%).
This study highlights the utility of integrating subjective and objective assessment tools in CTS diagnosis. The findings underscore the importance of comprehensive evaluation and suggest the potential value of TPT as an adjunctive diagnostic tool. Further research is warranted to validate these findings and refine diagnostic algorithms for CTS management.
腕管综合征（CTS）带来了重大的诊断挑战，尤其是在资源有限的环境中。诸如6项症状严重程度指数、定时Phalen试验（TPT）和CTS - 6等可靠工具很有前景，但研究不足。这些工具与症状严重程度之间的相关性仍未得到充分探索。
在临床诊断的CTS病例中，将6项症状严重程度指数和CTS - 6诊断工具与TPT进行相关性分析，评估它们的诊断性能。
在印度东部的一家三级护理医院进行前瞻性横断面研究。105名患者在满足纳入标准后入组，使用6项症状严重程度指数、CTS - 6诊断工具和TPT对他们进行评估。使用Pearson和Spearman相关系数，设定统计学显著性为<0.05。
在188只被评估的手中，TPT与CTS - 6评分呈显著负相关（r = -0.59，<0.0001），表明TPT值越高，评分越低。CTS - 6评分与症状严重程度呈正相关（r = 0.34，<0.0001），表明症状严重程度指数越高，诊断概率增加。TPT的阳性预测值为70.1%，敏感性为83.7%，特异性为61.1%。症状严重程度指数显示出较高的敏感性（100%）但较低的特异性（3.3%）。
本研究强调了在CTS诊断中整合主观和客观评估工具的实用性。研究结果强调了综合评估的重要性，并表明TPT作为辅助诊断工具的潜在价值。有必要进行进一步研究以验证这些发现并完善CTS管理的诊断算法。
