%0 Journal Article %T Diagnostic strategies using physical examination are minimally useful in defining carpal tunnel syndrome in population-based research studies. %+ Santé publique et épidémiologie des déterminants professionnels et sociaux de la santé %+ Division of General Medical Sciences %+ Department of Environmental Health Sciences %A Descatha, Alexis %A Dale, Ann-Marie %A Franzblau, Alfred %A Coomes, Justin %A Evanoff, Bradley %< avec comité de lecture %J Occup Environ Med %V 67 %N 2 %P 133-5 %8 2010-02 %D 2010 %R 10.1136/oem.2009.047431 %M 19854697 %Z Life Sciences [q-bio]/Santé publique et épidémiologieJournal articles %X OBJECTIVE: We evaluated the utility of physical examination manoeuvres in the prediction of carpal tunnel syndrome (CTS) in a population-based research study. METHODS: We studied a cohort of 1108 newly employed workers in several industries. Each worker completed a symptom questionnaire, a structured physical examination and nerve conduction study. For each hand, our CTS case definition required both median nerve conduction abnormality and symptoms classified as "classic" or "probable" on a hand diagram. We calculated the positive predictive values and likelihood ratios for physical examination manoeuvres in subjects with and without symptoms. RESULTS: The prevalence of CTS in our cohort was 1.2% for the right hand and 1.0% for the left hand. The likelihood ratios of a positive test for physical provocative tests ranged from 2.0 to 3.3, and those of a negative test from 0.3 to 0.9. The post-test probability of positive testing was <50% for all strategies tested. CONCLUSION: Our study found that physical examination, alone or in combination with symptoms, was not predictive of CTS in a working population. We suggest using specific symptoms as a first-level screening tool, and nerve conduction study as a confirmatory test, as a case definition strategy in research settings. %G English %2 https://inserm.hal.science/inserm-00468698/document %2 https://inserm.hal.science/inserm-00468698/file/descatha_CTS_shortreport_oem_manuscript_Onlinefirst.pdf %2 https://inserm.hal.science/inserm-00468698/file/inserm-00468698_edited.pdf %L inserm-00468698 %U https://inserm.hal.science/inserm-00468698 %~ INSERM %~ UNIV-PARIS5 %~ UNIV-PARIS1 %~ CNRS %~ UNIV-PSUD %~ EHESS %~ IFR69 %~ APHP %~ SANTE_PUB_INSERM %~ UVSQ %~ UNIV-PARIS-SACLAY %~ UNIV-PSUD-SACLAY %~ IRSET-10 %~ UNIV-PARIS