The diagnostic test performance of clinical point-of-care testing in relation to quantitative sensory testing for neurosensory injury among workers exposed to hand-arm vibration.

Abstract

Objectives: Early detection of neurosensory injury among workers exposed to hand-arm vibration is crucial. The aim of our study was to evaluate the diagnostic test performance of clinical point-of-care testing using a tuning fork and temperature rollers in relation to vibrotactile and thermal quantitative sensory testing.

Methods: We recruited 225 vibration-exposed workers who underwent clinical point-of-care testing using a Rydel Seiffer tuning fork and temperature rollers (25 and 40°C) applied to the distal phalanges of the index and little fingers bilaterally. Quantitative sensory testing was conducted at the same locations. Sensitivity, specificity, and other measures of diagnostic test performance were calculated.

Results: The study sample consisted of 208 men and 17 women with a median (IQR) age of 38 (26) years and with a median (IQR) hand-arm vibration exposure duration of 12 (21) years. Using vibrotactile quantitative sensory testing as the reference method, the sensitivity for the Rydel Seiffer tuning fork to detect reduced perception of vibration ranged from 30.0 to 61.1%, depending on the tested finger. The corresponding values for specificity were 91.1 to 94.4%. The sensitivity of temperature roller discrimination in relation to warm detection thresholds ranged from 31.6 to 48.2% and the specificity from 82.7 to 87.5%. The corresponding sensitivity of temperature roller discrimination in relation to cold detection thresholds ranged from 28.9 to 42.5% and the specificity from 86.0 to 94.7%.

Conclusions: The sensitivity of clinical point-of-care testing was rather low, indicating that quantitative sensory testing add value to the diagnostic procedure.