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Impacts of Differences in Epidemiological Case Definitions on Prevalence for Upper-Extremity Musculoskeletal Disorders

机译:流行病学病例定义上的差异对上肢肌肉骨骼疾病患病率的影响

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Objective: The aim of this study was to systematically evaluate prevalence based on variations in case definitions used for epidemiological studies of musculoskeletal disorders (MSDs). Background: Prior studies of MSDs have mostly relied on a single case definition based on questionnaires. Method: In a multicenter prospective cohort study, we systematically collected data to evaluate impacts of differences in case definitions of MSDs on prevalence of three common musculoskeletal disorders: (a) shoulder tendinosis, (b) lateral epicondylalgia, and (c) carpal tunnel syndrome. Production workers were from 21 employment settings in three diverse U.S. states and performed widely varying work. All workers completed laptop-administered structured interviews, two standardized physical examinations, and nerve conduction studies (NCS). Case definitions included symptoms only, and symptoms plus physical examinations and/or NCS. Results: A total of 1,227 subjects had complete health data at baseline. The prevalence for shoulder tendinosis is 23.0% if only glenohumeral pain is used for a case definition, compared with 8.0% if a combination of pain plus a positive supraspinatus test is used. The prevalence for lateral epicondylalgia varied on the basis of lateral elbow pain (12.0%), pain plus tenderness on palpation (9.9%), or pain plus tenderness on palpation plus resisted wrist or middle finger extension (3.5%). Carpal tunnel syndrome prevalence varied on the basis of tingling or numbness in a median nerve-served digit (29.9%) or tingling or numbness plus NCS abnormalities consistent with carpal tunnel syndrome (9.0%). Conclusion: Variations in epidemiological case definitions have major impacts on prevalence of common MSDs. Wide-ranging differences in prevalence may have impacts on purported risk factors that need to be determined.
机译:目的:本研究的目的是根据用于肌肉骨骼疾病(MSD)的流行病学研究中病例定义的变化,系统地评估患病率。背景:MSD的先前研究主要依赖于基于调查表的单个病例定义。方法:在一项多中心前瞻性队列研究中,我们系统地收集了数据以评估MSD病例定义的差异对三种常见的肌肉骨骼疾病的患病率的影响:(a)肩部肌腱病,(b)外侧上con肌痛和(c)腕管综合征。生产工人来自美国三个不同州的21个就业场所,从事着各种各样的工作。所有工人均完成了笔记本电脑管理的结构化访谈,两次标准化的体格检查和神经传导研究(NCS)。病例定义仅包括症状,症状以及体格检查和/或NCS。结果:共有1,227名受试者在基线时拥有完整的健康数据。如果仅使用盂肱关节痛来确定病例,则肩部肌腱炎的患病率为23.0%,而如果使用疼痛加脊柱上肌阳性试验的组合则为8.0%。外侧上con痛的患病率根据肘部外侧疼痛(12.0%),触诊疼痛加压痛(9.9%)或触诊疼痛加压痛加手腕或中指伸展抵抗(3.5%)而变化。腕管综合症的患病率根据神经服务中位数的刺痛或麻木(29.9%)或刺痛或麻木加上与腕管综合症一致的NCS异常(9.0%)而变化。结论:流行病学病例定义的变化对常见MSD的患病率有重大影响。患病率的广泛差异可能会影响据称需要确定的风险因素。

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