Association between Carpal Tunnel Cross-Sectional Area and Carpal Tunnel Syndrome: A Systematic Review and Meta-Analysis
Bibliographic record
Abstract
Background. Carpal tunnel syndrome (CTS) is a prevalent peripheral compressive neuropathy. In addition to an enlargement of the median nerve cross-sectional area (CSA), the carpal tunnel CSA may be a determinant of CTS. However, the findings of studies assessing the association between carpal tunnel CSA and CTS are very limited and inconclusive. Purpose. The present systematic review aimed to execute a meta-analysis of present literature to establish evidence of the association between the carpal tunnel CSA at the proximal and distal levels and CTS. Methods. PICOS strategy was used to electronically search key terms in the PubMed, Cochrane Library, Embase and Wiley Online databases with no restrictions on the publication date for case-control and cohort studies. The bias risks for these studies were assessed using the Newcastle-Ottawa Scale (NOS). Meta-analysis was performed using the RevMan5 from Cochrane. A total of 13 studies comparing the association between CSA of the carpal tunnel at the proximal and distal levels and CTS between 428 CTS participants and 324 controls with a 145/249 male-to-female ratio and a mean age of 42.2 met the inclusion criteria. Results. Overall, the studies were rated as acceptable quality, having scored 4, 6, 7, or 8 (out of 9 stars) on the NOS. Meta-analysis of the included studies indicated that the overall pooled mean difference of CSA of the carpal tunnel at the proximal level was higher in the CTS groups when compared with the control groups (0.79; 95% (confidence interval) CI 0.63-0.96; p = 0.003). Similarly, the overall pooled mean difference of CSA of the carpal tunnel at the distal level was higher in CTS individuals when compared with controls (0.54; 90%CI 0.32-0.76; p = 0.32). Conclusions. This review found evidence that an increased CSA of the carpal tunnel at the proximal and distal levels is associated with CTS.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.013 | 0.029 |
| Meta-epidemiology (narrow) | 0.003 | 0.002 |
| Meta-epidemiology (broad) | 0.018 | 0.036 |
| Bibliometrics | 0.010 | 0.010 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.003 | 0.002 |
| Open science | 0.002 | 0.002 |
| Research integrity | 0.003 | 0.002 |
| Insufficient payload (model declined to judge) | 0.004 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".