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dc.contributor.advisorJanzen, Bonnieen_US
dc.creatorBath, Brennaen_US
dc.date.accessioned2006-04-20T20:55:04Zen_US
dc.date.accessioned2013-01-04T04:29:30Z
dc.date.available2007-04-21T08:00:00Zen_US
dc.date.available2013-01-04T04:29:30Z
dc.date.created2006-02en_US
dc.date.issued2006-02-24en_US
dc.date.submittedFebruary 2006en_US
dc.identifier.urihttp://hdl.handle.net/10388/etd-04202006-205504en_US
dc.description.abstractStudy Design: A blinded, prospective diagnostic test study was conducted.Objectives: To assess the inter-tester reliability of clinical examination items for carpal tunnel syndrome (CTS), to assess the validity of individual clinical test items and self-report measures for the diagnosis of CTS and to assess the accuracy of an optimum test item cluster for the diagnosis of CTS.Study Rational: Examination of the diagnostic validity of various clinical tests for the diagnosis of CTS has shown mixed results and the reliability of many of these tests has not been determined. The majority of the diagnostic validity research for CTS has examined tests individually which is in contrast to clinical practice where the results of multiple tests are combined as part of the clinical reasoning process in order to formulate a differential diagnosis: the test item cluster, derived through logistic regression, is proposed as a means to integrate the validity of multiple tests. Methods: 37 subjects (74 “hands”) were recruited from a convenience sample of consecutive patients referred to for electrodiagnostic (EDX) testing due to upper extremity symptomatic complaints. Subjects underwent EDX testing followed by completion of self-report questionnaires and a standardized clinical examination by examiners blinded to EDX results. Diagnostic validity was determined for both “general” and “restricted” CTS classification groupings. Results: Out of 18 clinical test items, 12 had reliability coefficients (i.e. ICC or Kappa) of .40 or greater. There were 10 clinical exam and self-report items that were found to have likelihood point estimates above 2 or below 0.50 for the general diagnostic classification and 6 items had acceptable validity for the restricted classification. The test item cluster (TIC) derived for the general classification included “hand numbness” and symptom reproduction with the upper limb neurodynamic test 1. The TIC derived for the restricted classification included “hand numbness” and the overall score of the symptom component of the Bringham Carpal Tunnel Questionnaire. The 95% confidence intervals for most likelihood ratio point estimates were wide. Conclusions: The TICs for both classification groupings did not yield improved diagnostic validity beyond that found with the single best test item (“hand numbness”). The value of the single best test item “hand numbness” was in a negative response. Further investigation is required to validate the TIC and the single best test item and to improve the point estimate precision.en_US
dc.language.isoen_USen_US
dc.subjectBringham Carpal Tunnel Questionnaireen_US
dc.subjectDASHen_US
dc.subjectupper limb neurodynamic testsen_US
dc.subjectdiagnostic accuracyen_US
dc.titleReliability and diagnostic validity of clinical examination and patient self-report measures in carpal tunnel syndromeen_US
thesis.degree.departmentCommunity Health and Epidemiologyen_US
thesis.degree.disciplineCommunity Health and Epidemiologyen_US
thesis.degree.grantorUniversity of Saskatchewanen_US
thesis.degree.levelMastersen_US
thesis.degree.nameMaster of Science (M.Sc.)en_US
dc.type.materialtexten_US
dc.type.genreThesisen_US
dc.contributor.committeeMemberMuhajarine, Nazeemen_US
dc.contributor.committeeMemberLi Pi Shan, Rodneyen_US
dc.contributor.committeeMemberHarrison, Elizabeth L.en_US


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