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Atroshi I, Englund M, Turkiewicz A, Tägil M, Petersson IF. Incidence of Physician-Diagnosed Carpal Tunnel Syndrome in the General Population. Arch Intern Med. 2011;171(10):941–954. doi:10.1001/archinternmed.2011.203
Carpal tunnel syndrome (CTS) is a common cause of upper-extremity disability.1 Moderate to severe CTS often requires carpal tunnel release (CTR) surgery. A few studies have estimated the incidence of CTS, showing large differences between countries.2,3 Intercountry variations in incidence of surgery may reflect differences in CTS incidence and/or in use of surgical treatment. It is unknown whether such differences are age or sex related. In the present study, we estimate the incidence of physician-diagnosed CTS and surgery in the general population in southern Sweden and compare it with corresponding incidence in a US general population.
The Skåne Health Care Register (SHCR) is a comprehensive inpatient-outpatient register for Skåne County in southern Sweden (1.2 million inhabitants, one-eighth of Sweden's population). The SHCR covers all public health care providers (primary to tertiary) but not private physicians, accounting for 30% of patient visits.4 We retrieved SHCR data on all county residents who received a physician-made CTS diagnosis during 6 years (2003-2008). Persons with a first-time CTS diagnosis during the last 3 years (2006-2008) were considered incident cases. To account for cases exclusively diagnosed and managed by private physicians, incidence estimates were adjusted by reducing the at-risk population by 20% (level chosen because approximately one-third of patients cared for by private physicians are treated for the same condition by SHCR-covered physicians).5
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