{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T04:42:38Z","timestamp":1791261758460,"version":"4.1.0"},"reference-count":15,"publisher":"SAGE Publications","issue":"6","license":[{"start":{"date-parts":[[2019,3,10]],"date-time":"2019-03-10T00:00:00Z","timestamp":1552176000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Hand (New York, N,Y.)"],"published-print":{"date-parts":[[2020,11]]},"abstract":"<jats:p>Background: Nerve conduction studies (NCS), ultrasonography (US), Carpal Tunnel Syndrome 6 (CTS-6), Wainner, Lo, and Kamath are clinical diagnostic tools that can be used to diagnose carpal tunnel syndrome (CTS). Latent class analysis (LCA) is a proven statistical technique that can be used to evaluate diagnostic tests in a lack of a reference standard. Given that there is no accepted reference standard, we elected to perform an LCA to evaluate the 6 clinical diagnostic tests. Methods: One hundred eighty-seven wrists were prospectively evaluated by a board-certified hand surgeon using US, the CTS-6, Wainner, Lo, and Kamath. The NCS were performed by an electrophysiologist according to the standards of the American Association of Neuromuscular &amp; Electrodiagnostic Medicine. The LCA was performed to evaluate individual performance and pairwise combinations of the tests. Results: The NCS demonstrated the highest estimated sensitivity of 97%, and the Wainner had the highest estimated specificity of 97%. Alternatively, the Lo had the lowest estimated sensitivity (36%), and NCS had the lowest estimated specificity (40%). When evaluating pairwise combinations, positive US and NCS demonstrated the highest overall sensitivity at 86%, and negative US and NCS had a specificity of 83%. Conclusions: There is no perfect clinical diagnostic test, with the 6 clinical diagnostic tests having differing sensitivities and specificities. Pairwise combinations of the test can be used to complement one another.<\/jats:p>","DOI":"10.1177\/1558944719833709","type":"journal-article","created":{"date-parts":[[2019,3,11]],"date-time":"2019-03-11T02:35:32Z","timestamp":1552271732000},"page":"776-779","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":14,"title":["A Comparison of 6 Diagnostic Tests for Carpal Tunnel Syndrome Using Latent Class Analysis"],"prefix":"10.1177","volume":"15","author":[{"given":"William L.","family":"Wang","sequence":"first","affiliation":[{"name":"Thomas Jefferson University, Philadelphia, PA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Timothy","family":"Hanson","sequence":"additional","affiliation":[{"name":"University of South Carolina, Columbia, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John R.","family":"Fowler","sequence":"additional","affiliation":[{"name":"University of Pittsburgh, PA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2019,3,10]]},"reference":[{"key":"bibr1-1558944719833709","doi-asserted-by":"publisher","DOI":"10.1007\/s10072-009-0213-9"},{"key":"bibr2-1558944719833709","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.58.11.1589"},{"key":"bibr3-1558944719833709","doi-asserted-by":"publisher","DOI":"10.1016\/S0363-5023(96)80164-X"},{"key":"bibr4-1558944719833709","doi-asserted-by":"publisher","DOI":"10.2106\/JBJS.G.01362"},{"key":"bibr5-1558944719833709","doi-asserted-by":"publisher","DOI":"10.2106\/JBJS.M.01250"},{"key":"bibr6-1558944719833709","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhsa.2018.05.022"},{"key":"bibr7-1558944719833709","doi-asserted-by":"publisher","DOI":"10.2106\/JBJS.O.00476"},{"key":"bibr8-1558944719833709","doi-asserted-by":"publisher","DOI":"10.1002\/mus.22208"},{"key":"bibr9-1558944719833709","doi-asserted-by":"publisher","DOI":"10.1023\/A:1008929526011"},{"key":"bibr10-1558944719833709","doi-asserted-by":"publisher","DOI":"10.2307\/2530508"},{"key":"bibr11-1558944719833709","doi-asserted-by":"publisher","DOI":"10.1111\/j.1541-0420.2009.01330.x"},{"key":"bibr12-1558944719833709","doi-asserted-by":"publisher","DOI":"10.1007\/s11999-010-1637-5"},{"key":"bibr13-1558944719833709","doi-asserted-by":"publisher","DOI":"10.1302\/0301-620X.94B7.28704"},{"key":"bibr14-1558944719833709","doi-asserted-by":"publisher","DOI":"10.2106\/JBJS.K.00993"},{"key":"bibr15-1558944719833709","doi-asserted-by":"publisher","DOI":"10.1177\/1558944716646779"}],"container-title":["HAND"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/1558944719833709","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/1558944719833709","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/1558944719833709","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T07:30:01Z","timestamp":1777447801000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/1558944719833709"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,3,10]]},"references-count":15,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2020,11]]}},"alternative-id":["10.1177\/1558944719833709"],"URL":"https:\/\/doi.org\/10.1177\/1558944719833709","relation":{},"ISSN":["1558-9447","1558-9455"],"issn-type":[{"value":"1558-9447","type":"print"},{"value":"1558-9455","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,3,10]]}}}