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Critical analysis of outcome measures used in the assessment of carpal tunnel syndrome

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Abstract

Clinicians and researchers are confounded by the various outcome measures used for the assessment of carpal tunnel syndrome (CTS). In this study, we critically analysed the conceptual framework, validity, reliability, responsiveness and appropriateness of some of the commonly used CTS outcome measures. Initially, we conducted an extensive literature search to identify all of the outcome measures used in the assessment of CTS patients, which revealed six different carpal tunnel outcome measures [Boston Carpal Tunnel Questionnaire (BCTQ), Michigan Hand Outcome Questionnaire (MHQ), Disability of Arm, Shoulder and Hand (DASH), Patient Evaluation Measure (PEM), clinical rating scale (Historical-Objective (Hi-Ob) scale) and Upper Extremity Functional Scale (UEFS)]. We analysed the construction framework, development process, validation process, reliability, internal consistency (IC), responsiveness and limitations of each of these outcome measures. Our analysis reveals that BCTQ, MHQ and PEM have comprehensive frameworks, good validity, reliability and responsiveness both in the hands of the developers, as well as independent researchers. The UEFS and Hi-Ob scale need validation and reliability testing by independent researchers. Region-specific measures like DASH have good frameworks and, hence, a potential role in the assessment of CTS but they require more validation in exclusive carpal tunnel patients.

Résumé

Les cliniciens et les chercheurs sont submergés par le nombre de mesures utilisées pour l’évaluation du syndrome du canal carpien (CTS). Nous avons réalisé pour cette étude une étude critique de ces différentes mesures au travers de la littérature. Six différentes mesures sont utilisées : le questionnaire de Boston (BCTQ), le questionnaire de Michigan (MHQ), le score DASH, l’évaluation PEM, le questionnaire Hi-Ob scale et la mesure UEFS. Nous avons étudié sur tous les plans ces différents scores. Les mesures de type BCTQ, MHQ et PEM sont fidèles et utiles aussi bien pour les chirurgiens que pour les chercheurs. Les mesures UEFS et Hi-Ob scale nécessitent une validation par des examinateurs indépendants, la technique DASH nécessite une validation pour les patients présentant une lésion isolée du canal carpien.

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References

  1. Atroshi I, Johnsson R, Ornstein E (1998) Patient satisfaction and return to work after endoscopic carpal tunnel surgery. J Hand Surg [Am] 23(1):58–65

    Article  CAS  Google Scholar 

  2. Bindra RR, Dias JJ, Heras-Palau C, Amadio PC, Chung KC, Burke FD (2003) Assessing outcome after hand surgery: the current state. J Hand Surg [Br] 28(4):289–294

    CAS  Google Scholar 

  3. Chung KC, Hamill JB, Walters MR, Hayward RA (1999) The Michigan Hand Outcomes Questionnaire (MHQ): assessment of responsiveness to clinical change. Ann Plast Surg 42(6):619–622

    Article  PubMed  CAS  Google Scholar 

  4. Chung KC, Pillsbury MS, Walters MR, Hayward RA (1998) Reliability and validity testing of the Michigan Hand Outcomes Questionnaire. J Hand Surg [Am] 23(4):575–587

    Article  CAS  Google Scholar 

  5. Cohen J (1988) Statistical power analysis for the behavioural sciences, 2nd edn. Lawrence Earlbaum, Hillsdale, New Jersey

    Google Scholar 

  6. Dias JJ, Bhowal B, Wildin CJ, Thompson JR (2001) Assessing the outcome of disorders of the hand. Is the patient evaluation measure reliable, valid, responsive and without bias? J Bone Joint Surg Br 83(2):235–240

    Article  PubMed  CAS  Google Scholar 

  7. Gay RE, Amadio PC, Johnson JC (2003) Comparative responsiveness of the disabilities of the arm, shoulder, and hand, the carpal tunnel questionnaire, and the SF-36 to clinical change after carpal tunnel release. J Hand Surg [Am] 28(2):250–254

    Article  Google Scholar 

  8. Germann G, Harth A, Wind G, Demir E (2003) Standardisation and validation of the German version 2.0 of the Disability of Arm, Shoulder, Hand (DASH) questionnaire (in German). Unfallchirurg 106(1):13–19

    Article  PubMed  CAS  Google Scholar 

  9. Giannini F, Cioni R, Mondelli M, Padua R, Gregori B, D’Amico P, Padua L (2002) A new clinical scale of carpal tunnel syndrome: validation of the measurement and clinical-neurophysiological assessment. Clin Neurophysiol 113(1):71–77

    Article  PubMed  CAS  Google Scholar 

  10. Greenslade JR, Mehta RL, Belward P, Warwick DJ (2004) DASH and Boston Questionnaire assessment of carpal tunnel syndrome outcome: what is the responsiveness of an outcome questionnaire? J Hand Surg [Br] 29(2):159–164

    CAS  Google Scholar 

  11. Gummesson C, Atroshi I, Ekdahl C (2003) The disabilities of the arm, shoulder and hand (DASH) outcome questionnaire: longitudinal construct validity and measuring self-rated health change after surgery. BMC Musculoskelet Disord 4:11

    Article  PubMed  Google Scholar 

  12. Hobby JL, Watts C, Elliot D (2005) Validity and responsiveness of the patient evaluation measure as an outcome measure for carpal tunnel syndrome. J Hand Surg [Br] 30(4):350–354

    CAS  Google Scholar 

  13. Hudak PL, Amadio PC, Bombardier C (1996) Development of an upper extremity outcome measure: the DASH (disabilities of the arm, shoulder and hand) [corrected]. The Upper Extremity Collaborative Group (UECG). Am J Ind Med 29(6):602–608

    Article  PubMed  CAS  Google Scholar 

  14. Imaeda T, Toh S, Nakao Y, Nishida J, Hirata H, Ijichi M, Kohri C, Nagano A (2005) Validation of the Japanese Society for Surgery of the Hand version of the Disability of the Arm, Shoulder, and Hand questionnaire. J Orthop Sci 10(4):353–359

    Article  PubMed  Google Scholar 

  15. Jester A, Harth A, Wind G, Germann G, Sauerbier M (2005) Disabilities of the arm, shoulder and hand (DASH) questionnaire: determining functional activity profiles in patients with upper extremity disorders. J Hand Surg [Br] 30(1):23–28

    CAS  Google Scholar 

  16. Kotsis SV, Chung KC (2005) Responsiveness of the Michigan Hand Outcomes Questionnaire and the Disabilities of the Arm, Shoulder and Hand questionnaire in carpal tunnel surgery. J Hand Surg [Am] 30(1):81–86

    Article  Google Scholar 

  17. Landis JR, Koch GG (1977) The measurement of observer agreement for categorical data. Biometrics 33(1):159–174

    Article  PubMed  CAS  Google Scholar 

  18. Levine DW, Simmons BP, Koris MJ, Daltroy LH, Hohl GG, Fossel AH, Katz JN (1993) A self-administered questionnaire for the assessment of severity of symptoms and functional status in carpal tunnel syndrome. J Bone Joint Surg Am 75(11):1585–1592

    PubMed  CAS  Google Scholar 

  19. Macey AC, Burke FD, Abbott K, Barton NJ, Bradbury E, Bradley A, Bradley MJ, Brady O, Burt A, Brown P (1995) Outcomes of hand surgery. British Society for Surgery of the Hand. J Hand Surg [Br] 20(6):841–855

    CAS  Google Scholar 

  20. Mondelli M, Ginanneschi F, Rossi S, Reale F, Padua L, Giannini F (2002) Inter-observer reproducibility and responsiveness of a clinical severity scale in surgically treated carpal tunnel syndrome. Acta Neurol Scand 106(5):263–268

    Article  PubMed  CAS  Google Scholar 

  21. Pransky G, Feuerstein M, Himmelstein J, Katz JN, Vickers-Lahti M (1997) Measuring functional outcomes in work-related upper extremity disorders. Development and validation of the Upper Extremity Function Scale. J Occup Environ Med 39(12):1195–1202

    Article  PubMed  CAS  Google Scholar 

  22. Rosales RS, Delgado EB, Diez de la Lastra-Bosch I (2002) Evaluation of the Spanish version of the DASH and carpal tunnel syndrome health-related quality-of-life instruments: cross-cultural adaptation process and reliability. J Hand Surg [Am] 27(2):334–343

    Article  Google Scholar 

  23. Schuind FA, Mouraux D, Robert C, Brassinne E, Remy P, Salvia P, Meyer A, Moulart F, Burny F (2003) Functional and outcome evaluation of the hand and wrist. Hand Clin 19(3):361–369

    Article  PubMed  Google Scholar 

  24. Szabo RM (2001) Outcomes assessment in hand surgery: when are they meaningful? J Hand Surg [Am] 26(6):993–1002

    Article  CAS  Google Scholar 

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Authors and Affiliations

  1. Wrightington Hospital, Wigan, UK

    Senthil Nathan Sambandam

  2. Royal Albert Edward Infirmary, Wigan, UK

    P. Priyanka

  3. Swansea, UK

    Arif Gul

  4. Fairfield General Hospital, Bury, UK

    Balakrishnan Ilango

  5. 24 Dobson Close, Wigan, WN6 9ES, UK

    Senthil Nathan Sambandam

Authors
  1. Senthil Nathan Sambandam
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  2. P. Priyanka
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  3. Arif Gul
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  4. Balakrishnan Ilango
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Correspondence to Senthil Nathan Sambandam.

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Sambandam, S.N., Priyanka, P., Gul, A. et al. Critical analysis of outcome measures used in the assessment of carpal tunnel syndrome. International Orthopaedics (SICO 32, 497–504 (2008). https://doi.org/10.1007/s00264-007-0344-7

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  • DOI: https://doi.org/10.1007/s00264-007-0344-7

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