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A decision-analysis model to diagnose feigned hand weakness.

Ahmer K Ghori1, Kevin C Chung

  • 1University of Michigan School of Medicine, Ann Arbor, MI 48109-0340, USA.

The Journal of Hand Surgery
|December 12, 2007
PubMed
Summary
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Detecting feigned hand weakness, often seen in workers' compensation cases, requires advanced testing. Computerized grip measurement is the most specific and recommended second-line diagnostic tool for this condition.

Area of Science:

  • Occupational Medicine
  • Rehabilitation Medicine
  • Forensic Medicine

Background:

  • Malingering, the exaggeration of incapacity, is prevalent in workers' compensation.
  • Feigned hand weakness frequently occurs after work-related injuries, leading to significant societal costs.
  • Early detection of feigned hand weakness is crucial due to its prevalence and economic impact.

Purpose of the Study:

  • To evaluate diagnostic methods for feigned hand weakness.
  • To identify the most specific follow-up test for suspected malingering after initial clinical evaluation.

Main Methods:

  • Review of diagnostic approaches for feigned hand weakness.
  • Comparison of three advanced tests: five-rung grip test, rapid grip tests, and computerized grip measurement.

Related Experiment Videos

  • Assessment of specificity for each advanced test.

    • Main Results:

    • Clinical evaluation for feigned hand weakness lacks high specificity.
    • Advanced tests improve diagnostic accuracy.
    • Computerized measure of grip demonstrated the highest specificity among the evaluated tests.

    Conclusions:

    • Computerized grip measurement is the most specific and recommended second-line diagnostic test for feigned hand weakness.
    • Accurate diagnosis of malingering is essential for efficient resource allocation in workers' compensation systems.