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The Sensitivity and Specificity of Nerve Conduction Studies for Diagnosis of Carpal Tunnel Syndrome: A Systematic Review

机译：神经传导研究对脑隧道综合征诊断的敏感性和特异性：系统审查

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Background: The utility of nerve conduction studies (NCS) for diagnosis of carpal tunnel syndrome (CTS) has continued to be a subject of debate. Proponents of NCS assume a high sensitivity and specificity; however, many are unaware of the actual literature on this topic and the cutoff values commonly used for diagnosis. The purpose of this systematic review of the literature is to report the sensitivity and specificity of NCS for diagnosis of CTS in various studies. Methods: A literature review of PubMed and EMBASE databases was performed for all articles on NCS for diagnosis of CTS. The outcome of interest was the sensitivity and/or specificity of the NCS distal motor latency (DML) or distal sensory latency (DSL) cutoff value used to diagnose CTS in each study. Results: A total of 3066 total articles were screened and 21 were included in the review after assessment by two independent reviewers. The mean cut-off value for DSL was 3.37 ms (range 2.8-4 ms) and the mean cutoff value for DML was 4.28 ms (range 3.8-4.6 ms). Weighted mean DSL sensitivity was 73.4% and weighted mean DSL specificity was 93.6%. Weighted mean DML sensitivity was 56.2% and weighted mean DML specificity was 95.8%. Conclusions: There is significant variation in the cutoff values used for both DSL and DML. The wide range of cut-off values makes it difficult to interpret the literature, and there is a lack of high-quality studies with control groups using a priori cut-off values for diagnosis.
机译：背景：神经传导研究（NCS）用于诊断腕管综合征（CTS）的效用继续成为辩论的主题。 NCS的支持者假设高灵敏度和特异性;然而，许多人不知道这个话题的实际文献，以及常用于诊断的截止值。这种系统审查的目的是报告NCS在各种研究中诊断CTS的敏感性和特异性。方法：对NCS上的所有文章进行了PubMed和Embase数据库的文献回顾，用于诊断CTS。感兴趣的结果是NCS远端电机延迟（DML）或远端感官等待时间（DSL）截止值用于诊断CTS中CTS的敏感性和/或特异性。结果：共有3066篇总物品被筛查，21条由两个独立审稿人进行评估后审查。 DSL的平均截止值为3.37ms（范围2.8-4 ms），DML的平均截止值为4.28ms（范围3.8-4.6毫秒）。加权平均DSL敏感性为73.4％，加权平均DSL特异性为93.6％。加权平均DML敏感性为56.2％，加权平均DML特异性为95.8％。结论：用于DSL和DML的截止值存在显着变化。广泛的截止值使得难以解释文献，并且使用先验的截止值诊断，缺乏对对照组的高质量研究。

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