Abstract
Objective
To evaluate the accuracy of inlet and outlet ultrasonography measurements for the
diagnosis of carpal tunnel syndrome (CTS).
Data Sources
MEDLINE, EMBASE, the Cochrane Library, and the Web of Science databases were systematically
searched from inception to February 2017.
Study Selection
Observational studies comparing the diagnostic accuracy of inlet and outlet ultrasonography
measurements were selected.
Data Extraction
Random-effects models for the diagnostic odds ratio (dOR) values computed by Moses'
constant for a linear model and 95% confidence intervals (CIs) were used to calculate
the accuracy of the test. Hierarchical summary receiver operating characteristic curves
were used to summarize overall test performance.
Data Synthesis
Twenty-eight published studies were included in the meta-analysis. The pooled dOR
values for the diagnosis of CTS were 31.11 (95% CI, 20.42–47.40) for inlet-level and
16.94 (95% CI, 7.58–37.86) for outlet-level measurements. The 95% confidence region
for the point that summarizes overall test performance of the included studies occurred
where the cutoffs ranged from 9.0 to 12.6mm2 for inlet-level measurements and from 9.5 to 10.0mm2 for outlet-level measurements.
Conclusions
Both ultrasonography measurements for the diagnosis of CTS showed sufficient accuracy
for their use in clinical settings, although the overall accuracy was slightly higher
for inlet-level than for outlet-level measurements. The addition of outlet and inlet
measurements does not increase the accuracy for the diagnosis. Therefore, the inlet-level
ultrasonography measurement appears to be an appropriate method for the diagnosis
of CTS.
Keywords
List of abbreviations:
AUC (area under the curve), CI (confidence interval), CTS (carpal tunnel syndrome), dOR (diagnostic odds ratio), HSROC (hierarchical summary receiver operating characteristic), NLR (negative likelihood ratio), PLR (positive likelihood ratio)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: September 22, 2017
Footnotes
Supported by the Spanish Ministry of Education, Culture and Sport (grant no. FPU13/03137) to C.A.-B. and the University of Castilla-La Mancha (grant no. FPU13/01582) to I.C.-R.
PROSPERO Registration No.: CRD42017057722.
Disclosures: none.
Identification
Copyright
© 2017 by the American Congress of Rehabilitation Medicine
