[Skip to Content]
[Skip to Content Landing]
October 18, 2000

Clinical Diagnosis of Carpal Tunnel Syndrome

Author Affiliations

Stephen J.LurieMD, PhD, Senior EditorIndividualAuthorPhil B.FontanarosaMD, Executive Deputy EditorIndividualAuthor

JAMA. 2000;284(15a):1924-1925. doi:10.1001/jama.284.15.1921

To the Editor: To establish sensitivity, specificity, and likelihood ratios for a diagnostic test, the investigation must include both patients with and without the disease. However, in their review of carpal tunnel syndrome (CTS), Drs D'Arcy and McGee1 define likelihood ratios as the "odds that a given finding would occur in a patient with CTS as opposed to one without CTS," but they excluded articles with asymptomatic control groups. The use of asymptomatic control subjects ensures that patients are included who do not have any evidence of nerve compression. Thus, the 14 studies that D'Arcy and McGee excluded on this basis should have been included in the assessment of the CTS diagnostic criteria.