Utility of Nerve Conduction Studies for Carpal Tunnel Syndrome by Family Medicine, Primary Care, and Internal Medicine Physicians

Abstract

Nerve conduction studies (NCS) are increasingly being performed at the point-of-service by family medicine, primary care, and internal medicine (FM/PCP/IM) physicians. Carpal tunnel syndrome (CTS) is a common neuropathy often diagnosed with the aid of NCS. A retrospective analysis of a point-of-service NCS data registry was conducted; 1190 patients who underwent NCS by 613 FM/PCP/IM physician practices, for evaluation of CTS were analyzed. Utility measures included demographic and electrophysiological characteristics of study population, adherence to evidence-based testing guidelines, and relevance of diagnostic outcomes. Tested patients tended to be over 40, female, and overweight or obese. The median nerve distal motor latency was 4.4 +/- 1.2 ms; 92.6% of studies met the testing guideline; 30.5% of tested limbs yielded normal results; 53.1% CTS; 5.4% ulnar neuropathy; and 11.0% nonspecific upper extremity neuropathy. This study demonstrated that point-of-service NCS by FM/PCP/IM physicians for CTS was applied to appropriate patient subpopulations, was performed in accordance with evidence-based testing parameters, and generated relevant diagnostic outcomes.