Abstract：
BACKGROUND: Evidence-based practice for history-taking and physical examination in the evaluation of wrist complaints is limited.
OBJECTIVE: To create a set of recommended diagnostic tests for the clinical assessment of patients with undifferentiated wrist complaints.
METHODS: An e-Delphi study, following the recommendations on conducting and reporting Delphi studies, was performed.
METHODS: In this e-Delphi study, a national multidisciplinary panel of experts was invited to inventory diagnostic tests, based on several case scenarios, for the probability diagnosis in patients (age ≥18 years) with undifferentiated wrist complaints. Four case scenarios were constructed and presented to the expert panel members, which differed in age of the patient (35 vs 65 years), location (radial vs ulnar), and duration (6 vs 10 weeks) of the complaints. In consecutive rounds, the experts were asked to rate the importance of the inventoried diagnostic tests. Finally, experts were asked to rank recommended diagnostic tests for each case scenario.
RESULTS: Merging all results, the following diagnostic tests were recommended for all case scenarios: ask whether a trauma has occurred, ask how the complaints can be provoked, ask about the localization of the complaints, assess active ranges of motion, assess the presence of swelling, assess the difference in swelling between the left and right, assess the deformities or changes in position of the wrist, and palpate at the point of greatest pain.
CONCLUSIONS: This is the first scientific study where experts clinicians recommended diagnostic tests when assessing patients with undifferentiated wrist complaints, varying in age of the patient (35 vs 65 years), location (radial vs ulnar), and duration (6 vs 10 weeks).
OBJECTIVE: To create a set of recommended diagnostic tests for the clinical assessment of patients with undifferentiated wrist complaints.
METHODS: An e-Delphi study, following the recommendations on conducting and reporting Delphi studies, was performed.
METHODS: In this e-Delphi study, a national multidisciplinary panel of experts was invited to inventory diagnostic tests, based on several case scenarios, for the probability diagnosis in patients (age ≥18 years) with undifferentiated wrist complaints. Four case scenarios were constructed and presented to the expert panel members, which differed in age of the patient (35 vs 65 years), location (radial vs ulnar), and duration (6 vs 10 weeks) of the complaints. In consecutive rounds, the experts were asked to rate the importance of the inventoried diagnostic tests. Finally, experts were asked to rank recommended diagnostic tests for each case scenario.
RESULTS: Merging all results, the following diagnostic tests were recommended for all case scenarios: ask whether a trauma has occurred, ask how the complaints can be provoked, ask about the localization of the complaints, assess active ranges of motion, assess the presence of swelling, assess the difference in swelling between the left and right, assess the deformities or changes in position of the wrist, and palpate at the point of greatest pain.
CONCLUSIONS: This is the first scientific study where experts clinicians recommended diagnostic tests when assessing patients with undifferentiated wrist complaints, varying in age of the patient (35 vs 65 years), location (radial vs ulnar), and duration (6 vs 10 weeks).
摘要：
背景：在评估腕部投诉时，用于病史记录和体格检查的循证实践是有限的。
目的：创建一组推荐的诊断测试，用于临床评估未分化腕部不适患者。
方法：电子德尔菲研究，根据关于开展和报告德尔福研究的建议，已执行。
方法：在本e-Delphi研究中，邀请了一个国家多学科专家小组来盘点诊断测试，基于几个案例场景，对于未分化腕部主诉患者（年龄≥18岁）的概率诊断。构建了四个案例场景，并提交给专家小组成员，患者的年龄不同（35岁和65岁），位置（桡骨与尺骨），和投诉的持续时间(6vs10周)。在连续的回合中，专家们被要求对清单诊断测试的重要性进行评级。最后,专家被要求对每个病例方案的推荐诊断测试进行排名.
结果：合并所有结果，建议对所有病例进行以下诊断测试：询问是否发生了创伤，询问如何引发投诉，询问投诉的本地化情况，评估活动范围，评估肿胀的存在，评估左右肿胀的差异，评估手腕的畸形或位置变化，在最大的疼痛处触诊。
结论：这是第一项科学研究，专家临床医生在评估未分化腕部不适患者时建议进行诊断测试，患者年龄不同（35岁vs65岁），位置（桡骨与尺骨），和持续时间（6vs10周）。
目的：创建一组推荐的诊断测试，用于临床评估未分化腕部不适患者。
方法：电子德尔菲研究，根据关于开展和报告德尔福研究的建议，已执行。
方法：在本e-Delphi研究中，邀请了一个国家多学科专家小组来盘点诊断测试，基于几个案例场景，对于未分化腕部主诉患者（年龄≥18岁）的概率诊断。构建了四个案例场景，并提交给专家小组成员，患者的年龄不同（35岁和65岁），位置（桡骨与尺骨），和投诉的持续时间(6vs10周)。在连续的回合中，专家们被要求对清单诊断测试的重要性进行评级。最后,专家被要求对每个病例方案的推荐诊断测试进行排名.
结果：合并所有结果，建议对所有病例进行以下诊断测试：询问是否发生了创伤，询问如何引发投诉，询问投诉的本地化情况，评估活动范围，评估肿胀的存在，评估左右肿胀的差异，评估手腕的畸形或位置变化，在最大的疼痛处触诊。
结论：这是第一项科学研究，专家临床医生在评估未分化腕部不适患者时建议进行诊断测试，患者年龄不同（35岁vs65岁），位置（桡骨与尺骨），和持续时间（6vs10周）。
