Variations in diagnostic criteria for carpal tunnel syndrome among Ontario specialists

Abstract

BACKGROUND: Variations in diagnostic criteria for carpal tunnel syndrome (CTS) may result in differing reports of disease prevalence, errors in diagnosis, and variable results of treatment. The objective of this study was to determine how consistent specialists are in their ratings of the importance of clinical criteria for the diagnosis of CTS. METHODS: Three hundred specialist physicians and surgeons received a questionnaire containing 57 clinical criteria for the diagnosis of CTS. A visual analog scale (VAS) was used to rate the importance of each criterion in the diagnosis of CTS. RESULTS: The overall consistency both across and within specialties was poor (intraclass correlation coefficient across specialties (ICC) = 0.28; ICC range within specialties 0.27-0.37). CONCLUSIONS: Specialists are relatively inconsistent in the importance they assign to clinical criteria for the diagnosis of CTS. This inconsistency may be an important source of variation in the reported prevalence and treatment of CTS.