A handheld nerve conduction measuring device in carpal tunnel syndrome

Tolonen, U.; Kallio, Mika; Ryhänen, Jorma; Raatikainen, Timo; Honkala, V.; Lesonen, V.

doi:10.1111/j.1600-0404.2007.00799.x

Cited by 23 publications

(17 citation statements)

References 24 publications

(28 reference statements)

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“…The development of immunological rapid point‐of‐care (POC) and home‐based diagnostic tests, such as lateral flow assays, have greatly contributed to generating appropriate analytical results more rapidly, thereby accelerating patient management . In this regard, it seems crucial to collect biological samples within a short period of time, close to the patient location, with the aim of administrating the most adequate treatment to the patient, or of adjusting it quickly …”

Section: Discussionmentioning

confidence: 99%

“…56 In this regard, it seems crucial to collect biological samples within a short period of time, close to the patient location, with the aim of administrating the most adequate treatment to the patient, or of adjusting it quickly. 57 In previous publications, a new type of POC test, the paper-based analytical device, called PAD, was successfully developed for DENV NS1 proteins and specific IgM detection in various human biological samples. In both cases, the LOD was close to that obtained with a commercial rapid test.…”

Section: Discussionmentioning

confidence: 99%

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Detection of chikungunya virus‐specific IgM on laser‐cut paper‐based device using pseudo‐particles as capture antigen

Theillet

Grard

Galla

et al. 2019

Journal of Medical Virology

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The incidence of arbovirus infections has increased dramatically in recent decades, affecting hundreds of millions of people each year. The Togaviridae family includes the chikungunya virus (CHIKV), which is typically transmitted by Aedes mosquitoes and causes a wide range of symptoms from flu‐like fever to severe arthralgia. Although conventional diagnostic tests can provide early diagnosis of CHIKV infections, access to these tests is often limited in developing countries. Consequently, there is an urgent need to develop efficient, affordable, simple, rapid, and robust diagnostic tools that can be used in point‐of‐care settings. Early diagnosis is crucial to improve patient management and to reduce the risk of complications. A glass‐fiber laser‐cut microfluidic device (paper‐based analytical device [PAD]) was designed and evaluated in a proof of principle context, for the analysis of 30 µL of patient serum. Biological raw materials used for the functionalization of the PAD were first screened by MAC‐ELISA (IgM capture enzyme‐linked immunosorbent assay) for CHIKV Immunoglobulin M (IgM) capture and then evaluated on the PAD using various human samples. Compared with viral lysate traditionally used for chikungunya (CHIK) serology, CHIKV pseudo‐particles (PPs) have proven to be powerful antigens for specific IgM capture. The PAD was able to detect CHIKV IgM in human sera in less than 10 minutes. Results obtained in patient sera showed a sensitivity of 70.6% and a specificity of around 98%. The PAD showed few cross‐reactions with other tropical viral diseases. The PAD could help health workers in the early diagnosis of tropical diseases such as CHIK, which require specific management protocols in at‐risk populations.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Detection of chikungunya virus‐specific IgM on laser‐cut paper‐based device using pseudo‐particles as capture antigen

Theillet

Grard

Galla

et al. 2019

Journal of Medical Virology

View full text Add to dashboard Cite

show abstract

“…As previously stated, the goal is to collect the specimen, test, and obtain test results rapidly at or near the location of the patient so that the treatment plan can be adjusted, as needed, before the patient leaves the POC setting. 3 Smaller, easier-to-use, faster, smarter, and connected POCT devices have increased the use of POCT because it is now costeffective for diagnosis and management of many diseases, such as diabetes, carpal tunnel syndrome, 26 and acute coronary syndrome, while with the patient. In diabetes care, continuous glucose monitoring systems are in routine use.…”

Section: Poct Methodsmentioning

confidence: 99%

Point-of-Care Testing

DuBois¹,

Clarke²

2014

Point of Care: The Journal of Near-Patient Testing &Amp; Technology

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BACKGROUND P oint-of-care testing (POCT) is defined as medical testing at or near the site of patient care. 1-3 The first reported use of POCT appeared in the Ebers Papyrus dating from 1550 BC, in which Egyptian physicians used ants to determine glycosuria in patients suspected of having diabetes mellitus. The goal of POCT is to provide immediate, convenient, and easy-to-use diagnostic test(s) that shorten therapeutic turnaround time (TTAT) when providing patient care. Obtaining rapid diagnostic information allows for immediate clinical decision making, which improves patient safety and clinical outcomesnot to mention patient satisfaction. In the post-Medicare era, the model of centralized laboratory testing was developed and remained the norm until the mid-1980s, when new technologies were introduced and certain tests, most notably blood glucose and blood gases, began to migrate from the laboratory to patient care settings (Fig. 1). Although new instrumentation and methods have been developed that expand the laboratory industry's capabilities, the demand for rapid testing with shorter TTAT has prompted the significant increase in POCT. Since the evolution of blood glucose, blood gas, urinalysis, pregnancy, and coagulation testing in the mid-1990s, the POCT menu has expanded from less than 10 tests in 1995 to approximately 110 tests available today (Fig. 2). 4 In 2013, POCT represented 14% to 15% market share of the estimated $54 billion in vitro diagnostic (IVD) testing market, 5-10 and development of new technologies, such as lab-on-a-chip 11,12 and DNA-and RNA-based molecular diagnostic tests 13,14 are expected to further expand the POCT menu and increase utilization.Point-of-care testing is found in several care settings including hospital bedside, ambulatory care, alternate care (skilled nursing facilities), and the home (Fig. 3), and is used widely among major academic medical centers, hospitals, clinics, physician offices, and pharmaceutical clinical trial sites. Point-of-care testing also provides researchers with the ability to conduct double-blind studies using encrypted test results. It is important to note that POCT is not limited to the laboratory and includes physical tests such as weight, digital blood pressure, neurological tests, for example, carpal tunnel diagnostic test, and others. With the advent and expansion of retail pharmacies, certain point-of-care (POC) tests have benefit in supporting immediate treatment. Beyond glucose, POCT in the home-such as international normalized ratio-is positioned for major growth related to support management of chronic disease and companion diagnostics to support patient care. This is particularly important as the health care paradigm shifts to an accountable-care model focused on managing chronic diseases more effectively and providing preventive medical and wellness-based care.As summarized in Figure 4, care settings for POCT differ significantly regarding what is tested, who can perform the test, how the data are processed, and how the setting is regulate...

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“…In Oulu, Finland, a group of Clinical Neurophysiologists developed a hand-held device for diagnosing the median nerve lesion in CTS based on the work of Uncini et al [6] A clinical trial to prove its effectiveness was performed [7], but was slow to recruit patients in a country with a population of only five million people. Finpro, an agency set up to support Finnish innovation contacted the Department of Health in the UK to locate clinical partners that could help validate the system further.…”

Section: Introductionmentioning

confidence: 99%

Carpal tunnel syndrome diagnosis: validation of a clinic-based nerve conduction measurement device

Green¹,

Kallio²,

Clarke³

et al. 2011

JBiSE

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Background: Carpal Tunnel Syndrome (CTS) is the commonest upper limb nerve entrapment syndrome seen in practice. In many centres, nerve conduction studies (NCS) have been adopted as a routine part of the diagnostic process. In the United Kingdom, the time taken to access diagnostic tests has been likened to a “hidden waiting list”, lengthening the time taken for a patient to access treatment. In the current healthcare climate with a centrally driven aim to reduce patient waiting time to a maximum of eighteen weeks, including tests, such waiting is even more unacceptable. Aim. This study was performed in order to evaluate a simple handheld device for quantifying median nerve lesions in CTS. Design of study: A prospective blinded cohort study. Setting: Leicester General Hospital, Carpal Tunnel Service Method: Participants were recruited from the nor-mal referral stream. If the clinical findings were consistent with a diagnosis of CTS, they were for-mally consented to the study in which results from the new handheld device were compared with traditional NCS. Final test group consisted of 63 participants. Results: For the new device the correct positive detection rate for abnormal nerve conduction was 91% (74/81 hands). Of the seven abnormal results not picked up by the new device, four were in asymptomatic hands (positive per cent agree-ment in symptomatic hands 95%). There were no false positives with the new system. (Negative per cent agreement 100%) Conclusion: We conclude that this new device demonstrates a high degree of concordance with currently available traditional NCS. The study suggested ways in which the accuracy could be further improved

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A handheld nerve conduction measuring device in carpal tunnel syndrome

Abstract: The findings obtained with the new tester in CTS were reliable and reproducible. This tester may increase availability of NCS in CTS.

Cited by 23 publications

References 24 publications

Detection of chikungunya virus‐specific IgM on laser‐cut paper‐based device using pseudo‐particles as capture antigen

Detection of chikungunya virus‐specific IgM on laser‐cut paper‐based device using pseudo‐particles as capture antigen

Point-of-Care Testing

Carpal tunnel syndrome diagnosis: validation of a clinic-based nerve conduction measurement device

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