International Orthopaedics

, Volume 33, Issue 1, pp 181–185 | Cite as

Assessing the clinical significance of change scores following carpal tunnel surgery

  • Rouin Amirfeyz
  • Alanna Pentlow
  • Julian Foote
  • Ian Leslie
Original Paper


This article presents a prospective longitudinal study to determine the cut-off values for change scores of DASH, Levine, and Kamath questionnaires to distinguish clinical improvement following carpal tunnel surgery. Fifty-four patients (40 female, 14 male), with positive nerve conduction studies, were prospectively followed up. Three questionnaires (DASH, Levine, and Kamath) were posted to patients at four and two weeks prior to their operation and then six weeks following surgery. A patient global impression of change (PGIC) score was completed for patients to rate the overall change in their symptoms. According to the PGIC, 93% of patients improved. The cut-off values for raw change scores that best define clinically significant improvement following carpal tunnel release were 20.9 for DASH, 0.47 for Levine, and 1.97 for the Kamath questionnaire. This study provides a methodological framework for identifying clinically significant changes following treatment. A questionnaire follow-up of patients is now possible using the data provided.


Etude prospective longitudinale dans le but de déterminer les valeurs seuils, les scores DASH, de LEVINE et de KAMATH correspondant à l’amélioration clinique après chirurgie du canal carpien. 54 patients (40 femmes et 14 hommes), ayant un électromyogramme positif ont été suivis de manière prospective. 3 questionnaires (DASH, LEVINE et KAMATH) ont été envoyés aux patients à 4 et 2 semaines avant leur intervention et à 6 semaines après l’intervention. Un score d’impression globale de changement subjectif (PGIC) a été rempli par les patients pour mesurer les changements survenus dans leur symptomatologie. 93% des patients ont été améliorés selon le score PGIC. Les valeurs seuils de changement brut des scores correspondant le mieux à l’amélioration clinique suivant la chirurgie de libération du canal carpien étaient 20.9 pour le DASH, 0.47 pour le LEVINE et 1.97 pour le KAMATH. Cette étude fournit une base méthodologique pour identifier les améliorations cliniques significative après traitement. Le suivi des patients par questionnaire est maintenant possible par l’utilisation des données fournies.


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Copyright information

© Springer-Verlag 2007

Authors and Affiliations

  • Rouin Amirfeyz
    • 1
    • 3
  • Alanna Pentlow
    • 1
  • Julian Foote
    • 1
  • Ian Leslie
    • 2
  1. 1.Trauma & OrthopaedicsAvon Orthopaedic CentreBristolUK
  2. 2.Trauma & OrthopaedicsBristol Royal InfirmaryBristolUK
  3. 3.BristolUK

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