Diagnostic accuracy of sensory and motor tests for the diagnosis of carpal tunnel syndrome: a systematic review

Table 6 Diagnostic Accuracy of Hand Grip Strength, Pinch Grip Strength, Thumb Abduction Weakness, Thenar Atrophy, and Functional dexterity tests for CTS diagnosis

Study (Authors, year)	Sensitivity (%)	Specificity (%)	PPV (%)	NPV (%)	+LR	-LR
Hand (palmar) grip strength
Franzblau et al. 1993 [22]	RS#1 10	RS#1 90	RS#1 15	RS#1 85	RS#1 1*	RS#1 1*
	RS#2 10	RS#2 90	RS#2 15	RS#2 85	RS#2 1*	RS#2 1*
	RS#3 32	RS#3 94	RS#3 47	RS#3 89	RS#3 5.33*	RS#3 0.72*
Szabo et al. 1999 [29]	48 (95% CI 26–70)	30 (95% CI 14–46)	1%P = 1 5%P = 3 10%P = 7 15%P = 11 20%P = 15	1%P = 98 5%P = 92 10%P = 84 15%P = 77 20%P = 70	0.68*	1.73*
Pinch grip strength
Franzblau et al. 1993 [22]	RS#1 10	RS#1 93	RS#1 20	RS#1 85	RS#1 1.42*	RS#1 0.96*
	RS#2 20	RS#2 95	RS#2 39	RS#2 87	RS#2 4*	RS#2 0.84*
	RS#3 21	RS#3 95	RS#3 41	RS#3 87	RS#3 4.2*	RS#3 0.83*
MacDermid et al. 1997 [26]	Tester 1 = 72 Tester 2 = 70	Tester 1 = 88 Tester 2 = 78	NR	NR	Tester 1 = 6.00* Tester 2 = 3.18*	Tester 1 = 0.31* Tester 2 = 0.38*
Thumb abduction weakness
Kuhlman et al. 1997 [24]	66	66	76	54	1.94*	0.51*
Makanji et al. 2013 [11]	37	73	80	28	1.37*	0.86*
Raudino 2000 [28]	12.1	NR	NR	NR	NR	NR
Thenar atrophy
Kucukakkas & Yurdakul 2019 [7]	22 (95% CI 17–28)	100 (95% CI 98–100)	100	57 (95% CI 56–59)	Infinite*	0.78*
Makanji et al. 2013 [11]	18	96	92	29	4.5*	0.85*
Naranjo et al. 2007 [9]	5.5	100	NR	NR	Infinite	0.95
Functional dexterity test
Sartorio et al. 2017 [10]	84 (95% CI 72–90)	64 (95% CI 41–82)	NR	NR	2.37 (95% CI, 1.23–4.55)	0.25 (95% CI, 0.13–0.49)

PPV Positive Predictive Value, NPV Negative Predictive Value, +LR Positive Likelihood Ratio, −LR Negative Likelihood Ratio, CI confidence Interval, NR Not Reported, RS reference standard
In Franzblau et al. ‘s study, the first reference standard was electrodiagnosis, the second reference standard was electrodiagnosis and symptoms consistent with CTS, and the third reference standard was physical examination findings and symptoms consistent with CTS;
In Szabo’s study, the positive and negative predicted values were calculated based on five hypothetical CTS prevalence, which were 1, 5, 10, 15, and 20% which we reported separately in the table;
* values calculated by the authors of this study

ISSN: 1471-2474