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Carpal tunnel syndrome is the most common entrapment neuropathy. The cause of this syndrome is hard to determine, but it can include trauma, repetitive maneuvers, certain diseases, and pregnancy. Three commonly used tests for carpal tunnel syndrome are Tinel’s sign, Phalen’s test, and the nerve conduction velocity test. Tinel’s sign and Phalen’s test are both highly sensitive (0.98 and 0.92, respectively) and specific (0.91 and 0.88, respectively). The sensitivity and specificity of the nerve conduction velocity test are 0.93 and 0.87, respectively.1 Assume that the tests are conditionally independent. Calculate the sensitivity and specificity of a combined test if combining is done (a) in a serial manner;2 (b) in a parallel manner.3 (c) Find Positive Predictive Value (PPV) for the tests in (a) and (b) if the prevalence of carpal tunnel syndrome in the general population is approximately 50 cases per 1000 subjects.

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