ABSTRACT
OBJECTIVE: To study the demographic characteristics of patients with carpal tunnel syndrome and changes in incidence over time. METHODS: Prospective collection of neurophysiological and clinical data on all patients presenting to the subregional department of clinical neurophysiology in Canterbury, UK, from 1992 to 2001 and to the electromyography clinic in St Luke's Hospital, Huddersfield, UK, from 1991 to 1993. RESULTS: 6245 new cases of neurophysiologically confirmed carpal tunnel syndrome were identified in Canterbury and 590 in Huddersfield. The average annual incidences (per 100,000) were 139.4 for women and 67.2 for men in East Kent, and 83.2 for women and 48.0 for men in Huddersfield. Corrected to the WHO European standard population these rates were 120.5 for women and 60.0 for men in East Kent, and 61.5 for women and 35.0 for men in Huddersfield. Between 1992 and 2001 there was an increase in the number of confirmed cases in East Kent but a decrease in their average severity. The age distributions were bimodal with a peak in the 50-54 age group and a second peak between 75 and 84 years. Over half the cases were bilateral. The disorder was consistently worse in the elderly, and more severe in men than in women in all age groups. CONCLUSIONS: The age distributions of unselected cases of carpal tunnel syndrome in both clinics differ markedly from that usually portrayed in surgical series. There was a significant increase in cases diagnosed between 1992 and 2001 in Canterbury, probably the result of increased ascertainment of milder cases. Median nerve impairment is more severe in the elderly and in men at all ages.
Subject(s)
Carpal Tunnel Syndrome/epidemiology , Population Surveillance , Adult , Age Distribution , Aged , Aged, 80 and over , Carpal Tunnel Syndrome/physiopathology , Female , Humans , Incidence , Male , Middle Aged , Severity of Illness Index , Sex Distribution , Time Factors , United Kingdom/epidemiologyABSTRACT
This paper aims to compare and contrast two types of model (logistic regression and decision tree induction) for the diagnosis of carpal tunnel syndrome using four ordered classification categories. Initially, we present the classification performance results based on more than two covariates (multivariate case). Our results suggest that there is no significant difference between the two methods. Further to this investigation, we present a detailed comparison of the structure of bivariate versions of the models. The first surprising result of this analysis is that the classification accuracy of the bivariate models is slightly higher than that of the multivariate ones. In addition, the bivariate models lend themselves to graphical analysis, where the corresponding decision regions can easily be represented in the two-dimensional covariate space. This analysis reveals important structural differences between the two models.
Subject(s)
Carpal Tunnel Syndrome/diagnosis , Diagnosis, Computer-Assisted/methods , Algorithms , Carpal Tunnel Syndrome/classification , Carpal Tunnel Syndrome/physiopathology , Decision Trees , Evaluation Studies as Topic , Humans , Logistic Models , Multivariate AnalysisABSTRACT
Details of the development and testing of a microcomputer-based statistical decision aid for screening carpal tunnel syndrome are given. The clinical and operational details have been reported in (14).
Subject(s)
Carpal Tunnel Syndrome/diagnosis , Diagnosis, Computer-Assisted/instrumentation , Microcomputers , Software , Electromyography , Humans , Logistic Models , Neural Conduction/physiology , Reaction Time/physiologyABSTRACT
We investigated the relationship between impairment, as represented by limitation in range of movement and pain in the knee joint, and disability as measured by a series of activities of daily living in 123 patients with either rheumatoid arthritis or osteoarthrosis. A log-linear modelling technique found there was a positive association between functional limitation, as measured by reduction in angle of flexion, and disability. However, there was only a marginal relationship between pain in the knee joint and disability, and no association between pain and range of movement, which suggests that conventional beliefs that pain is a key factor in assessing health outcomes may need to be reassessed.
Subject(s)
Arthritis, Rheumatoid/physiopathology , Osteoarthritis/physiopathology , Adolescent , Adult , Aged , Aged, 80 and over , Disability Evaluation , Female , Humans , Knee Joint/physiopathology , Linear Models , Male , Middle Aged , Movement , Pain/psychologyABSTRACT
A detailed study has been carried out on the influence of various factors, including sex of the patient and side examined, on normal values in peripheral nerve conduction studied. Patients were selected from three clinics, thereby enabling comparisons not only to be made within clinics but also between clinics.
