{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,5,3]],"date-time":"2025-05-03T04:10:52Z","timestamp":1746245452125,"version":"3.40.4"},"reference-count":26,"publisher":"Public Library of Science (PLoS)","issue":"3","license":[{"start":{"date-parts":[[2025,3,25]],"date-time":"2025-03-25T00:00:00Z","timestamp":1742860800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100010731","name":"Faculty of Medicine, Chiang Mai University","doi-asserted-by":"publisher","award":["Grant number 046\/2565. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript."],"award-info":[{"award-number":["Grant number 046\/2565. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript."]}],"id":[{"id":"10.13039\/501100010731","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>\nObjective\n<\/jats:title>\n<jats:p>The CTS-6 Evaluation Tool is a clinical diagnostic tool for carpal tunnel syndrome. It was originally developed using data\u00a0from non-disabled individuals and has never been validated in different population. This study aimed to validate CTS-6\u2019s diagnostic performance at a cutoff score of 12 in a new population of wheelchair users.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>\nMethods\n<\/jats:title>\n<jats:p>The participants were 54 Thai wheelchair users from a university hospital\u2019s neuropathy registry. Those with a history of nerve injury, fracture, neuropathy, or pregnancy were excluded from the study. All underwent clinical exam, CTS-6, and electrodiagnosis (blinded evaluator). Carpal tunnel syndrome was diagnosed based on clinical symptoms and electrodiagnostic criteria.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>\nResults\n<\/jats:title>\n<jats:p>Of 54 participants, 13 were female (24.1%) with an average age of 46.9 (SD 12.2) years, and 18 (33.3%) participants had carpal tunnel syndrome. Duration of disability (years) was significantly longer in cases; median 24 (Q<jats:sub>1<\/jats:sub> 19.0, Q<jats:sub>3<\/jats:sub> 28.9), p\u2009&lt;\u20090.001. Discriminative performance: Area under the receiver operating curve 0.935 (95%CI:0.891-0.978). At the 12 cutoff point, the\u00a0sensitivity was 43.8% (95%CI:26.4-62.3%) and the specificity\u00a0was\u00a0100.0% (95%CI:94.8-100.0%). A lower cutoff point showed increased sensitivity and specificity. Symptomatic subgroup analysis showed similar diagnostic performances.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec004\">\n<jats:title>\nConclusion\n<\/jats:title>\n<jats:p>The CTS-6 Evaluation Tool is a simple clinical diagnostic tool that does not require\u00a0sophisticated investigation. The CTS-6\u2019s discriminative ability remains strong. The diagnostic performance at a cutoff score of 12 showed moderate sensitivity and high specificity. Applying a cutoff score of 12 could help\u00a0rule in the\u00a0diagnosis where access to electrodiagnosis is limited. A lower cutoff score that is 7.5 could be applied as a screening test to rule out the diagnosis, as it provides\u00a0moderately higher sensitivity at the cost of increased false positives.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0319158","type":"journal-article","created":{"date-parts":[[2025,5,2]],"date-time":"2025-05-02T18:13:52Z","timestamp":1746209632000},"page":"e0319158","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":0,"title":["The validation of the CTS-6 Evaluation Tool for diagnosing carpal tunnel syndrome (CTS) in Thai wheelchair 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