Buschbacher R
Indiana University Medical Center, Indianapolis 46202-5111, USA.
J Bone Joint Surg Am. 1997 Mar;79(3):401-5. doi: 10.2106/00004623-199703000-00013.
A prospective study of 217 patients was performed to determine the sensitivity and specificity of standard manual testing and of a new method, termed confrontational testing, for detecting weakness of the intrinsic muscles of the hand. Electrodiagnostic testing was used to identify the presence of any neurological disorder and to provide a control for the manual testing methods. Standard manual testing of the muscles innervated by the ulnar nerve revealed a sensitivity of 14 per cent, a specificity of 100 per cent, a predictive value of a positive result of 100 per cent, and a predictive value of a negative result of 57 per cent. Confrontational testing of the muscles innervated by the ulnar nerve revealed a sensitivity of 82 per cent, a specificity of 100 per cent, a predictive value of a positive result of 100 per cent, and a predictive value of a negative result of 87 per cent. Standard manual testing of the muscles innervated by the median nerve revealed a sensitivity of 6 per cent, a specificity of 100 per cent, a predictive value of a positive result of 100 per cent, and a predictive value of a negative result of 49 per cent. Confrontational testing of the muscles innervated by the median nerve revealed a sensitivity of 16 per cent, a specificity of 100 per cent, a predictive value of a positive result of 100 per cent, and a predictive value of a negative result of 52 per cent.
对217例患者进行了一项前瞻性研究，以确定标准手法检查以及一种称为对抗试验的新方法在检测手部固有肌肌力减弱方面的敏感性和特异性。采用电诊断检查来确定是否存在任何神经疾病，并为手法检查方法提供对照。对尺神经支配肌肉的标准手法检查显示，敏感性为14%，特异性为100%，阳性结果预测值为100%，阴性结果预测值为57%。对尺神经支配肌肉的对抗试验显示，敏感性为82%，特异性为100%，阳性结果预测值为100%，阴性结果预测值为87%。对正中神经支配肌肉的标准手法检查显示，敏感性为6%，特异性为100%，阳性结果预测值为100%，阴性结果预测值为49%。对正中神经支配肌肉的对抗试验显示，敏感性为16%，特异性为100%，阳性结果预测值为100%，阴性结果预测值为52%。
