A 15-Year Review of Clinical Practice Patterns in Carpal Tunnel Syndrome Based on Continuous Certification by the American Board of Plastic Surgery

Abstract

iplomates of the American Board of Plastic Surgery submit procedure logs every 3 years to maintain continuous certification, intending to improve surgical outcomes in selected disciplines. Data from 20 different operative categories, each constituting a tracer, are subdivided into four modules: Comprehensive, Cosmetic, Craniomaxillofacial, and Hand. Plastic surgeons may report on 10 consecutive cases in a tracer of their choice, reporting on presentation, operative techniques, and outcomes during the preceding 3-year period.Since 2004, the American Board of Plastic Surgery has compiled tracer data on carpal tunnel release through the Continuous Certification Program. Evaluation of cumulative tracer data provides insight into both the current practice patterns and changes in those practice patterns since the onset of data collection. This exercise allows practicing plastic surgeons to compare their surgical experience in treating carpal tunnel syndrome to their peers. In addition, the data present the opportunity to analyze trends in relation to current best practices.

A 15-Year Review of Clinical Practice Patterns in Carpal Tunnel Syndrome Based on Continuous Certification by the American Board of Plastic Surgery

“…The recent article by Sasson et al, 1 entitled “A 15-Year Review of Clinical Practice Patterns in Carpal Tunnel Syndrome Based on Continuous Certification by the American Board of Plastic Surgery,” is both thorough and compelling. However, one statement merits further comment: “In breaking with evidence-based recommendations, these studies,” referring to electrodiagnostic tests and imaging with magnetic resonance or ultrasound, “were performed on the majority of patients.…”

Reply: A 15-Year Review of Clinical Practice Patterns in Carpal Tunnel Syndrome Based on Continuous Certification by the American Board of Plastic Surgery

“…We wish to thank Dr. Walker for his thoughtful comment on our article. 1 Dr. Walker has highlighted in his commentary several recent studies showing a high level of evidence in support of ultrasound utilization in carpal tunnel syndrome diagnosis and against the widespread use of certain physical examination maneuvers such as the scratch collapse test, due to their low reliability. 2–4 The comment we cited by Hermiz and Kalliainen, 5 indicating that electrodiagnostic studies add little to the diagnosis of carpal tunnel syndrome, was published as part of the American Board of Plastic Surgeons’ evidence-based medicine series in 2017.…”

“…Our data demonstrate that 76% of patients underwent electrodiagnostic testing, indicating that our diplomates are following evidence-based medicine in their practice. 1…”