Comparative Diagnostic Performance of Vibration Perception Thresholds and clinical indicators in Sensorineural Hand-Arm Vibration Syndrome. A Study of Sensitivity, Specificity, Predictive value, Accuracy and ROC AUC.

OBJECTIVE: To examine the diagnostic performances (sensitivity, specificity, positive and negative predictive values, accuracy, and receiver operating characteristic area under the curve (ROC-AUC)) in sensorineural Hand-Arm Vibration Syndrome (HAVS-SN). METHODS: In a retrospective study, clinical data were evaluated in 180 workers referred to HAVS assessment 2007-2019. Diagnostic performances were analyzed with clinical diagnosis serving as the reference standard. RESULTS: Vibration Perception Thresholds (VPTs), measured with Quantitative Sensory Testing (QST), demonstrated superior diagnostic performance: sensitivity 93% (95% CI: 81-99%), specificity 82% (68-92%), positive predictive value 90% (83-94%), negative predictive value 87% (69-95%), accuracy 89% (80-95%), and ROC-AUC 0.88. This outperformed sharp/soft sensibility tests (ROC-AUC 0.68), self-reported numbness (specificity: 33%, ROC-AUC 0.67), and other assessments. CONCLUSIONS: QST by measurement of VPTs was the most accurate single diagnostic test for HAVS-SN.