Article
Using Carpal Tunnel Questionnaire in Clinical Practice: An Update on Measurement Properties
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Published: | February 6, 2020 |
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Objective: Carpal Tunnel Questionnaire (CTQ) is a disease-specific measure that examines symptom severity (SSS) and functional status (FSS) via two separate scales in individuals with carpal tunnel syndrome (CTS). This systematic review provides state of the art evidence for using CTQ in clinical practice.
Materials and Methods: Pubmed, AMED, CINAHL, and PsychInfo databases were searched in October 2017 using pre-defined keywords to locate studies that assessed at least one measurement property for the CTQ in CTS patients. Two separate reviewers independently appraised the quality of eligible studies using standardized appraisal form. Relevant studies were weighted based on their sample size and methodological quality. Indices of reliability, internal consistency, responsiveness, and true or important clinical change were pooled based on these weights to derive composite data for these indices.
Results: A total of 33 studies that examined at least one measurement property of the CTQ were included. The quality of the studies assessed by two independent raters ranged from 38-88% with excellent agreement between raters in quality assessment (weighted kappa 0.86; 0.80-0.91 confidence bounds). The SSS and FSS showed expected concurrent relationships with measures assessing pain or disability in CTS patients. Pooled intraclass correlation coefficient was 0.85 for SSS and 0.86 for FSS suggesting very good test-retest reliability. Pooled standard error of measurements and minimal detectable change at 90% confidence for SSS/FSS were 0.27/0.33 and 0.64/0.77 respectively. Lastly, the pooed effect sizes for the SSS and FSS were 1.51 and 0.82 respectively suggesting excellent responsiveness.
Conclusions: Our results provide a strong support for using the CTQ in assessing impairment in patients with CTS. Our results also provide key statistics that should enable interpretation of the scores of CTQ obtained in a patient at a given assessment or determining whether true change has occurred at follow-up assessment.