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

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.

The Effects of Oscillatory Biofield Therapy on Pain and Functional Limitations Associated with Carpal Tunnel Syndrome: Randomized, Placebo-Controlled, Double-Blind Study

“…The Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire was used to measure changes in participants' upper-extremity functional abilities. 31,32 5. The Levine outcome assessment questionnaire 33 was used for measuring changes in functional abilities of the patients.…”

Validity, reliability and ease of use of the disabilities of arm, shoulder and hand questionnaire in adults following stroke

“…Importantly for clinical use, the DASH has also been found to be simple for therapists and patient participants to complete and score; the time taken to complete the DASH ranges from three minutes to 13 minutes [16,[20][21][22] making its use in rehabilitation settings attractive.…”

“…Psychometric examination of the DASH with musculoskeletal populations (arthritis, shoulder and elbow arthroplasty, Colles fracture, proximal humeral fracture and carpal tunnel syndrome) found it to be reliable [11][12][13][14][15], valid [16][17][18][19] and simple to administer [16,[20][21][22].…”

Do Electrodiagnostic Variables Correlate with Functional Outcomes in Carpal Tunnel Syndrome?

“…Other reasons include additional expense, delays in initiating care, unneeded inconvenience, discomfort to the patient, and subjectivity involved in severity assessment on the part of the electrodiagnostician. Additionally, the use of the DASH questionnaire allows clinicians to International Journal of Physical Medicine & Rehabilitation Kasitinon et follow patient changes over time and therefore evaluate the efficacy of treatment interventions [7].…”