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Grip Strength as a Screening Index for Severe Degenerative Cervical Myelopathy in Primary Care: Development of Cutoff Values Using Receiver Operating Curve Analysis

PURPOSE: Early diagnosis of degenerative cervical spondylosis (DCM) is desirable because late treatment can lead to irreversible sequelae. No screening method has yet been established. Grip strength is commonly used in primary care settings to evaluate disease activity and diagnose sarcopenia. This...

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Autores principales: Kobayashi, Hiroshi, Otani, Koji, Nikaido, Takuya, Watanabe, Kazuyuki, Kato, Kinshi, Handa, Junichi, Yabuki, Shoji, Konno, Shin-Ichi
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Dove 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8702987/
https://www.ncbi.nlm.nih.gov/pubmed/34984020
http://dx.doi.org/10.2147/IJGM.S336541
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author Kobayashi, Hiroshi
Otani, Koji
Nikaido, Takuya
Watanabe, Kazuyuki
Kato, Kinshi
Handa, Junichi
Yabuki, Shoji
Konno, Shin-Ichi
author_facet Kobayashi, Hiroshi
Otani, Koji
Nikaido, Takuya
Watanabe, Kazuyuki
Kato, Kinshi
Handa, Junichi
Yabuki, Shoji
Konno, Shin-Ichi
author_sort Kobayashi, Hiroshi
collection PubMed
description PURPOSE: Early diagnosis of degenerative cervical spondylosis (DCM) is desirable because late treatment can lead to irreversible sequelae. No screening method has yet been established. Grip strength is commonly used in primary care settings to evaluate disease activity and diagnose sarcopenia. This single-center, cross-sectional study aimed to determine the diagnostic accuracy of grip strength for cervical myelopathy (DCM) and cutoff values for primary care DCM screening using area under the curve (AUC) and sensitivity values. PATIENTS AND METHODS: The DCM group comprised 249 consecutive participants (165 males, 84 females; mean age, 65.1 years) with DCM who had undergone surgery at the affiliated hospital. The control group comprised 735 (280 males, 455 females; mean age, 65.8 years) participants undertaking a local government health checkup. Stratifying by age and sex, receiver operating characteristic (ROC) analyses were constructed for each group using minimum grip strength values for both hands. Based on ROC analysis, cut-off values were established so that the screening sensitivity would be 90% for either sex or age group, respectively. RESULTS: According to age group and sex (males/females [M/F]), AUC values for a diagnosis of DCM in M/F were as follows: 40–59 years, 0.92/0.87; 60–69 years, 0.94/0.89; 70–79 years, 0.89/0.91; and 80–89 years, 0.97/0.97. Calculated M/F cutoff values were 41/24.5, 27/16, 27/15, and 20/10 kg, which were similar to cutoff scores for sarcopenia in M/F patients aged 60–69 and 70–79 years. M/F sensitivities in each age groups were 0.94/0.91, 0.92/0.90, 0.95/0.96, and 0.92/0.93. M/F specificities were 0.62/0.59, 0.84/0.83, 0.61/0.71, and 0.83/0.88. CONCLUSION: Grip strength had moderate-to-high diagnostic accuracy for DCM between participants in the control and DCM groups. We developed easily applicable cutoff values for primary care DCM screening with ≥90% sensitivity. In patients with sarcopenia, DCM should be differentially diagnosed in primary care.
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spelling pubmed-87029872022-01-03 Grip Strength as a Screening Index for Severe Degenerative Cervical Myelopathy in Primary Care: Development of Cutoff Values Using Receiver Operating Curve Analysis Kobayashi, Hiroshi Otani, Koji Nikaido, Takuya Watanabe, Kazuyuki Kato, Kinshi Handa, Junichi Yabuki, Shoji Konno, Shin-Ichi Int J Gen Med Original Research PURPOSE: Early diagnosis of degenerative cervical spondylosis (DCM) is desirable because late treatment can lead to irreversible sequelae. No screening method has yet been established. Grip strength is commonly used in primary care settings to evaluate disease activity and diagnose sarcopenia. This single-center, cross-sectional study aimed to determine the diagnostic accuracy of grip strength for cervical myelopathy (DCM) and cutoff values for primary care DCM screening using area under the curve (AUC) and sensitivity values. PATIENTS AND METHODS: The DCM group comprised 249 consecutive participants (165 males, 84 females; mean age, 65.1 years) with DCM who had undergone surgery at the affiliated hospital. The control group comprised 735 (280 males, 455 females; mean age, 65.8 years) participants undertaking a local government health checkup. Stratifying by age and sex, receiver operating characteristic (ROC) analyses were constructed for each group using minimum grip strength values for both hands. Based on ROC analysis, cut-off values were established so that the screening sensitivity would be 90% for either sex or age group, respectively. RESULTS: According to age group and sex (males/females [M/F]), AUC values for a diagnosis of DCM in M/F were as follows: 40–59 years, 0.92/0.87; 60–69 years, 0.94/0.89; 70–79 years, 0.89/0.91; and 80–89 years, 0.97/0.97. Calculated M/F cutoff values were 41/24.5, 27/16, 27/15, and 20/10 kg, which were similar to cutoff scores for sarcopenia in M/F patients aged 60–69 and 70–79 years. M/F sensitivities in each age groups were 0.94/0.91, 0.92/0.90, 0.95/0.96, and 0.92/0.93. M/F specificities were 0.62/0.59, 0.84/0.83, 0.61/0.71, and 0.83/0.88. CONCLUSION: Grip strength had moderate-to-high diagnostic accuracy for DCM between participants in the control and DCM groups. We developed easily applicable cutoff values for primary care DCM screening with ≥90% sensitivity. In patients with sarcopenia, DCM should be differentially diagnosed in primary care. Dove 2021-12-18 /pmc/articles/PMC8702987/ /pubmed/34984020 http://dx.doi.org/10.2147/IJGM.S336541 Text en © 2021 Kobayashi et al. https://creativecommons.org/licenses/by-nc/3.0/This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License (http://creativecommons.org/licenses/by-nc/3.0/ (https://creativecommons.org/licenses/by-nc/3.0/) ). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms (https://www.dovepress.com/terms.php).
spellingShingle Original Research
Kobayashi, Hiroshi
Otani, Koji
Nikaido, Takuya
Watanabe, Kazuyuki
Kato, Kinshi
Handa, Junichi
Yabuki, Shoji
Konno, Shin-Ichi
Grip Strength as a Screening Index for Severe Degenerative Cervical Myelopathy in Primary Care: Development of Cutoff Values Using Receiver Operating Curve Analysis
title Grip Strength as a Screening Index for Severe Degenerative Cervical Myelopathy in Primary Care: Development of Cutoff Values Using Receiver Operating Curve Analysis
title_full Grip Strength as a Screening Index for Severe Degenerative Cervical Myelopathy in Primary Care: Development of Cutoff Values Using Receiver Operating Curve Analysis
title_fullStr Grip Strength as a Screening Index for Severe Degenerative Cervical Myelopathy in Primary Care: Development of Cutoff Values Using Receiver Operating Curve Analysis
title_full_unstemmed Grip Strength as a Screening Index for Severe Degenerative Cervical Myelopathy in Primary Care: Development of Cutoff Values Using Receiver Operating Curve Analysis
title_short Grip Strength as a Screening Index for Severe Degenerative Cervical Myelopathy in Primary Care: Development of Cutoff Values Using Receiver Operating Curve Analysis
title_sort grip strength as a screening index for severe degenerative cervical myelopathy in primary care: development of cutoff values using receiver operating curve analysis
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8702987/
https://www.ncbi.nlm.nih.gov/pubmed/34984020
http://dx.doi.org/10.2147/IJGM.S336541
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