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Atcheson et al¹ attempted to evaluate the association between work-related carpal tunnel syndrome (CTS) and (1) predisposing medical conditions (diabetes mellitus, hypothyroidism, various arthropathies, unclassified inflammatory disorders, and others) and (2) occupational group. There are serious methodological flaws that limit the conclusions that may be drawn from these data: detection bias, inappropriate choice of a comparison group, and misclassification of exposure to occupational ergonomic risk factors. In addition to the methodological problems, we question the authors' interpretation of the reported results.

The data represent clinical findings from medical evaluations performed by Atcheson at the request of workers' compensation insurance carriers. The subjects are workers' compensation claimants who had previously been diagnosed as having work-related disorders of the elbow, forearm, wrist, or hand, including CTS. The authors compare the prevalence of concurrent medical conditions and occupational categories among those with work-related CTS with those with other work-related upper extremity disorders. When . . . [Full Text of this Article]

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RELATED ARTICLE

Concurrent Medical Disease in Work-Related Carpal Tunnel Syndrome
Steven G. Atcheson, John R. Ward, and Wing Lowe
Arch Intern Med. 1998;158(14):1506-1512.
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