TY - JOUR
T1 - Diagnostic test accuracy of Tinel’s test in adults with carpal tunnel syndrome—a systematic review
AU - Gopal, Sivashnie
AU - Minns Lowe, Catherine
AU - Kumaran, Binoy
N1 - © 2024 Informa UK Limited, trading as Taylor & Francis Group. This is the accepted manuscript version of an article which has been published in final form at https://doi.org/10.1080/10833196.2024.2411178
PY - 2024/10/9
Y1 - 2024/10/9
N2 - Background: Tinel’s test is commonly used in the diagnosis of carpal tunnel syndrome (CTS) despite its questionable diagnostic test accuracy (DTA). This systematic review investigated the DTA of Tinel’s test in CTS using electrodiagnosis as the reference standard and explored the heterogeneity between included studies. Methods: Prospective studies evaluating Tinel’s test in adults with CTS were included. The principal measures were sensitivity and specificity. A literature search was conducted for studies published up to 7 June 2024. The methodological quality was assessed using the QUADAS-2 tool. Narrative synthesis of study results and heterogeneity was undertaken. Meta-analysis was not conducted due to the high variability in diagnostic thresholds. Results: Fifteen out of 4099 identified studies met the inclusion criteria. Patient selection scored ‘high’ in risk of bias and applicability concerns. Examiner blinding was poorly reported. Sensitivity varied from 30 to 89%. Specificity varied from 41 to 100%. Heterogeneity was found across all studies in participant selection criteria, Tinel’s test performance, electrodiagnostic criteria, and diagnostic thresholds. Conclusions: Tinel’s test demonstrated variable diagnostic accuracy in CTS. Due to poor methodological quality and high variability among the studies, more DTA studies are necessary. PROSPERO Protocol number: CRD42020218165 dated 27 November 2020.
AB - Background: Tinel’s test is commonly used in the diagnosis of carpal tunnel syndrome (CTS) despite its questionable diagnostic test accuracy (DTA). This systematic review investigated the DTA of Tinel’s test in CTS using electrodiagnosis as the reference standard and explored the heterogeneity between included studies. Methods: Prospective studies evaluating Tinel’s test in adults with CTS were included. The principal measures were sensitivity and specificity. A literature search was conducted for studies published up to 7 June 2024. The methodological quality was assessed using the QUADAS-2 tool. Narrative synthesis of study results and heterogeneity was undertaken. Meta-analysis was not conducted due to the high variability in diagnostic thresholds. Results: Fifteen out of 4099 identified studies met the inclusion criteria. Patient selection scored ‘high’ in risk of bias and applicability concerns. Examiner blinding was poorly reported. Sensitivity varied from 30 to 89%. Specificity varied from 41 to 100%. Heterogeneity was found across all studies in participant selection criteria, Tinel’s test performance, electrodiagnostic criteria, and diagnostic thresholds. Conclusions: Tinel’s test demonstrated variable diagnostic accuracy in CTS. Due to poor methodological quality and high variability among the studies, more DTA studies are necessary. PROSPERO Protocol number: CRD42020218165 dated 27 November 2020.
KW - Carpal tunnel syndrome
KW - Tinel’s test
KW - diagnostic test accuracy
KW - median nerve
UR - http://www.scopus.com/inward/record.url?scp=85206099193&partnerID=8YFLogxK
U2 - 10.1080/10833196.2024.2411178
DO - 10.1080/10833196.2024.2411178
M3 - Review article
SN - 1083-3196
SP - 1
EP - 12
JO - Physical Therapy Reviews
JF - Physical Therapy Reviews
M1 - 2411178
ER -