Abstract：
OBJECTIVE: The diagnosis of carpal tunnel syndrome (CTS) can be made clinically using the Carpal Tunnel Syndrome-6 (CTS-6) criteria. The role of electrodiagnostic studies (EDS) is controversial. We examined differences in the utilization of CTS-6 and EDS based on surgeon experience and practice setting.
METHODS: Members of the American Society for Surgery of the Hand were emailed an anonymous web-based link to participate. The survey included an assessment of hypothetical CTS scenarios with varying clinical severity. We collected surgeon demographic attributes, years in practice, practice setting, and frequency of CTS-6 and EDS utilization. A comparison was made of years of experience with surgeon-reported utilization of CTS-6 and EDS as well as treatment recommendation.
RESULTS: We received 771 responses (25% response rate). Surgeons recommended carpal tunnel release (CTR) for patients without EDS (16%), normal EDS (33%), and abnormal EDS (90%). Fifty-three percent of surgeons with <15 years in practice reported often/always using CTS-6 criteria in their practice compared to 30% and 29% of surgeons with 16-30 years and > 30 years in practice, respectively. Surgeons with 16-30 and >30 years in practice had significantly lower odds of reporting often/almost always using CTS-6 relative to surgeons with 1-15 years in practice (OR 0.35 and 0.31, respectively). A greater proportion of surgeons with 16-30 years (68%) and >30 years (65.5%) in practice responded often/almost always applying EDS compared to surgeons with <15 years (56%) in practice. In addition, surgeons with 16-30 years and >30 years in practice had a higher odds of often/always using EDS (ORs 1.74 and 1.98, respectively) compared to surgeons with 1-15 years in practice (P < .05).
CONCLUSIONS: Utilization of CTS-6 and EDS varied based on years in practice. This difference may reflect changing guidelines, the growing evidence regarding clinical assessment tools, and the emergence of other diagnostic modalities.
CONCLUSIONS: Given the expense and invasiveness of EDS, opportunities to integrate clinical assessment tools readily into the diagnostic algorithm may shift the role of EDS toward selective utilization for complex clinical scenarios rather than for routine use.
METHODS: Members of the American Society for Surgery of the Hand were emailed an anonymous web-based link to participate. The survey included an assessment of hypothetical CTS scenarios with varying clinical severity. We collected surgeon demographic attributes, years in practice, practice setting, and frequency of CTS-6 and EDS utilization. A comparison was made of years of experience with surgeon-reported utilization of CTS-6 and EDS as well as treatment recommendation.
RESULTS: We received 771 responses (25% response rate). Surgeons recommended carpal tunnel release (CTR) for patients without EDS (16%), normal EDS (33%), and abnormal EDS (90%). Fifty-three percent of surgeons with <15 years in practice reported often/always using CTS-6 criteria in their practice compared to 30% and 29% of surgeons with 16-30 years and > 30 years in practice, respectively. Surgeons with 16-30 and >30 years in practice had significantly lower odds of reporting often/almost always using CTS-6 relative to surgeons with 1-15 years in practice (OR 0.35 and 0.31, respectively). A greater proportion of surgeons with 16-30 years (68%) and >30 years (65.5%) in practice responded often/almost always applying EDS compared to surgeons with <15 years (56%) in practice. In addition, surgeons with 16-30 years and >30 years in practice had a higher odds of often/always using EDS (ORs 1.74 and 1.98, respectively) compared to surgeons with 1-15 years in practice (P < .05).
CONCLUSIONS: Utilization of CTS-6 and EDS varied based on years in practice. This difference may reflect changing guidelines, the growing evidence regarding clinical assessment tools, and the emergence of other diagnostic modalities.
CONCLUSIONS: Given the expense and invasiveness of EDS, opportunities to integrate clinical assessment tools readily into the diagnostic algorithm may shift the role of EDS toward selective utilization for complex clinical scenarios rather than for routine use.
摘要：
目的：腕管综合征（CTS）的诊断可在临床上使用腕管综合征-6（CTS-6）标准。电诊断研究（EDS）的作用是有争议的。我们根据外科医生的经验和实践设置检查了CTS-6和EDS利用的差异。
方法：美国手外科学会的成员通过电子邮件通过基于网络的匿名链接参与。该调查包括对具有不同临床严重程度的假设CTS情景的评估。我们收集了外科医生的人口统计属性，多年的实践，练习设置,以及CTS-6和EDS使用的频率。对外科医生报告的CTS-6和EDS的使用以及治疗建议的多年经验进行了比较。
结果：我们收到了771份回复（回复率为25%）。外科医生建议腕管松解术（CTR）用于无EDS的患者（16％），正常EDS（33%），和异常的EDS（90％）。53％的外科医生在实践中<15年报告经常/总是使用CTS-6标准，相比之下，30％和29％的外科医生在实践中16-30年和>30年。分别。与实践1-15年的外科医生相比，实践16-30年和>30年的外科医生经常/几乎总是使用CTS-6报告的几率显着降低（OR分别为0.35和0.31）。与实践中<15岁（56％）的外科医生相比，实践中16-30岁（68％）和>30岁（65.5％）的外科医生经常/几乎总是应用EDS。此外,与实践1-15年的外科医生相比,实践16-30年和>30年的外科医生经常/总是使用EDS的几率更高(分别为1.74和1.98)(P<.05).
结论：CTS-6和EDS的利用根据实践年份而变化。这种差异可能反映了准则的变化，关于临床评估工具的证据越来越多，以及其他诊断方式的出现。
结论：考虑到EDS的费用和侵入性，将临床评估工具很容易地整合到诊断算法中的机会可能会将EDS的作用转向对复杂临床情景的选择性利用,而不是常规使用.
方法：美国手外科学会的成员通过电子邮件通过基于网络的匿名链接参与。该调查包括对具有不同临床严重程度的假设CTS情景的评估。我们收集了外科医生的人口统计属性，多年的实践，练习设置,以及CTS-6和EDS使用的频率。对外科医生报告的CTS-6和EDS的使用以及治疗建议的多年经验进行了比较。
结果：我们收到了771份回复（回复率为25%）。外科医生建议腕管松解术（CTR）用于无EDS的患者（16％），正常EDS（33%），和异常的EDS（90％）。53％的外科医生在实践中<15年报告经常/总是使用CTS-6标准，相比之下，30％和29％的外科医生在实践中16-30年和>30年。分别。与实践1-15年的外科医生相比，实践16-30年和>30年的外科医生经常/几乎总是使用CTS-6报告的几率显着降低（OR分别为0.35和0.31）。与实践中<15岁（56％）的外科医生相比，实践中16-30岁（68％）和>30岁（65.5％）的外科医生经常/几乎总是应用EDS。此外,与实践1-15年的外科医生相比,实践16-30年和>30年的外科医生经常/总是使用EDS的几率更高(分别为1.74和1.98)(P<.05).
结论：CTS-6和EDS的利用根据实践年份而变化。这种差异可能反映了准则的变化，关于临床评估工具的证据越来越多，以及其他诊断方式的出现。
结论：考虑到EDS的费用和侵入性，将临床评估工具很容易地整合到诊断算法中的机会可能会将EDS的作用转向对复杂临床情景的选择性利用,而不是常规使用.
