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October 8, 2003

The Value of Diagnostic Tests for Low Back Pain—Reply

Author Affiliations

Letters Section Editor: Stephen J. Lurie, MD, PhD, Senior Editor.

JAMA. 2003;290(14):1853-1855. doi:10.1001/jama.290.14.1853-a

In Reply: In response to Dr Nathan and colleagues, we think that our study recognizes the multifactorial nature of tingling and numbness in the hands. However, our findings do not call for a long-term longitudinal study of the etiology of CTS among computer users. The cohort would have to be so large that the efforts would outweigh the benefits if nerve conduction studies were used to assess CTS. We feel quite confident that our diagnostic method is reliable. As we stated, the exact same diagnostic approach but including nerve conduction tests has been used and validated in another longitudinal study of CTS.1,2 Therefore, we know that both the prevalence and incidence would have dropped to approximately one third of the interview values if nerve conduction tests had been included.

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