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With the continuous trend to smaller mobile devices with more functionality and more wireless bands, the possible insufficient over-the-air (OTA) becomes a growing concern for service providers. In addition to reduced radiation efficiency by smaller antennas in smaller phones, the head and in particular the hand may further impair radiation performance. The aim of this paper is to investigate the influence of the various parameters of the hand upon the OTA performance criteria to support the standardization process of the hand phantom and to provide the tools for optimization of handheld transmitters. The results reveal the following order of significance for small variations in hand parameters: 1) position of index finger; 2) distance between phone case and palm; 3) position of the other fingers; 4) size of the hand; 5) dielectric parameters; 6) wrist length and tilt. Some configurations may lead to a slight increase of the peak spatial SAR in the head. OTA assessment without the hand does not provide a good measure of phone performance in real life. However, good reproducibility of evaluations requires a precise definition of the hand, in particular its geometry and the phone position within the hand.