Method: This meta-analysis utilized PUBMED, EMBASE, and Cochrane databases, adhering to PRISMA guidelines, to examine individuals with peripheral nerve injuries (PNIs). It compared electrodiagnostic studies to PSSD in terms of sensitivity, specificity, and predictive values. The study included adults aged 18 and older with diagnosed peripheral injury and neuropathy, focusing on nerve conduction studies and pressure-specific measurements. It excluded studies involving myography or motor studies and articles that were reviews of primary research or other systematic reviews. Data extraction for the meta-analysis followed a risk bias assessment.
Results: Out of 182 screened references, 106 duplicates were removed, resulting in 76 unique studies. After screening titles and abstracts, 67 were excluded, and 9 underwent full-text assessment, leading to 5 exclusions (4 for wrong comparator, 1 for wrong design). Ultimately, 4 studies were included, analyzing 411 individuals with an average age of 49.75 years, including 16.1% males, focusing on diabetes mellitus and carpal tunnel syndrome. When comparing PSSD to EDT as the gold standard, PSSD showed 486 True Positives (TP), 42 True Negatives (TN), 192 False Positives (FP), and 18 False Negatives (FN), resulting in a Sensitivity of 96.4% and Specificity of 17.9%. Using Clinical Diagnosis (CD) as the gold standard, PSSD produced TP = 1173, TN = 309, FP = 153, FN = 243, with Sensitivity at 82.8% and Specificity at 66.9%. When comparing EDT to CD, results were TP = 1101, TN = 324, FP = 138, FN = 315, resulting in Sensitivity of 77.8% and Specificity of 70.1%.
Conclusion: PSSD has a high sensitivity which makes it useful for excluding diabetic neuropathies and nerve entrapments. Compared to PSSD, the EDT possesses a marginal superiority in specificity. Nevertheless, PSSD also offers the notable benefit of being significantly less invasive and painful, which enhances its applicability in clinical contexts.
