Development of a clinical prediction rule for the diagnosis of cubital tunnel syndrome in Thai wheelchair users.
Purpose: To develop and internally validate a clinical prediction rule (CPR) for diagnosing cubital tunnel syndrome (CuTS) in wheelchair users. To the authors' knowledge, no prior diagnostic CPR for CuTS was developed. Methods: Participants were wheelchair users with spinal cord injuries/lesions age...
| Publicado en: | Disability & Rehabilitation: Assistive Technology Vol. 20; no. 6; pp. 1792 - 1800 |
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| Autores principales: | , , , , , , |
| Formato: | research tables/charts Journal Article |
| Publicado: |
Taylor & Francis Ltd
Aug2025
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=187408896&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 187408896 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 17483107 1X04 jtl: Disability & Rehabilitation: Assistive Technology issn: 17483107 maglogo: Y pubinfo: dt: Aug2025 vid: 20 iid: 6 pid: 377 pub: Taylor & Francis Ltd place: Philadelphia, Pennsylvania artinfo: ui: 187408896 183889727 187408896 187408896 10.1080/17483107.2025.2477680 187408896 ppf: 1792 ppct: 8 formats: fmt: – @attributes: type: T – @attributes: type: P tig: atl: Development of a clinical prediction rule for the diagnosis of cubital tunnel syndrome in Thai wheelchair users. aug: au: Kitisak, Kittipong Tongprasert, Siam Luengutaisilp, Niracha Phinyo, Phichayut Atthakomol, Pichitchai Nantasukasem, Kulanan Buntragulpoontawee, Montana affil: Department of Rehabilitation Medicine, Faculty of Medicine, Neuro-Mobility Unit, Chiang Mai University, Chiang Mai, Thailand sug: subj: Persons with Disabilities Wheelchairs Utilization Cubital Tunnel Syndrome Diagnosis Predictive Value of Tests Sensitivity and Specificity Clinical Prediction Rules Human Male Female Adult Middle Age Aged Thailand Academic Medical Centers Prospective Studies Nonexperimental Studies Cross Sectional Studies Outpatient Service Outpatients Scales Electrodiagnosis Hypesthesia Descriptive Statistics Data Analysis Software Multiple Logistic Regression ROC Curve Funding Source Ulnar Nerve Compression Syndromes Diagnosis Ulnar Neuropathies Diagnosis Prediction Models Grip Strength Exercise Test, Muscular Adult: 19-44 years Middle Aged: 45-64 years Aged: 65+ years Male Female ab: Purpose: To develop and internally validate a clinical prediction rule (CPR) for diagnosing cubital tunnel syndrome (CuTS) in wheelchair users. To the authors' knowledge, no prior diagnostic CPR for CuTS was developed. Methods: Participants were wheelchair users with spinal cord injuries/lesions aged ≥20 years. All underwent clinical examinations and electrodiagnostic studies. Clinical endpoint was a confirmed CuTS diagnosis; clinical symptoms and positive electrodiagnostic criteria. The CPR was developed using multivariable logistic regression with backward elimination. Coefficients of the selected predictors were converted into scores by division of the lowest coefficient and then rounded off to the closest integer. Internal validation was performed using bootstrap technique. The model's discriminative ability and calibration performance were evaluated. Results: Seventy-seven wheelchair users (142 arms) were included, 28(19.7%) arms had CuTS. Multivariable analysis identified three statistically significant predictors for the final diagnostic model: numbness or tingling in the fourth (ulnar half) and fifth fingers, grip weakness and a positive elbow flexion test; "The CuTS-3 Diagnostic Score" (CuTS-3). The CuTS-3 demonstrated good discriminative ability; area under the receiver operating characteristic (AuROC) = 0.88 (95%CI: 0.82–0.95) and calibration. The bootstrap performance adjusted for the estimated optimism for the clinical endpoint was 0.869 (95%CI 0.797–0.946). A cut-off score of ≥2 was suggested for diagnosis as it showed good sensitivity (89.3%) and specificity (78.1%). Conclusions: The CuTS-3 is a simple and well-performing diagnostic CPR. General clinical use is encouraged to help detecting and providing timely CuTS management. In the future, the model would benefit from external validation in different population. IMPLICATIONS FOR REHABILITATION: The CuTS-3 was developed specifically for wheelchair users with good discriminative ability and calibration performance. The CuTS-3 can be applied in routine clinical settings regardless of the clinical expertise level, as it contains only three simple predictors. The CuTS-3 score results can also be applied for guiding management decision. The CuTS-3 could be included in a long-term follow-up program for early intervention to prevent further disabilities in wheelchair users. pubtype: Academic Journal doctype: research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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